方法：前瞻性研究。分析2012-01/2015-01在我院眼科治疗的全视网膜激光光凝后继发黄斑水肿患者72例72眼的临床资料。所有患者均因患有严重的糖尿病视网膜病变而行全视网膜激光光凝治疗，治疗后出现不同程度的视网膜黄斑区水肿，或原有黄斑水肿加重。按照随机原则分为2组：行玻璃体腔注射TA(0.025mL，1mg)，简称注射组36眼； 口服羟苯磺酸钙胶囊，简称口服组36眼。观察两组治疗前，治疗后1、3、6mo的最佳矫正视力(best corrected visual acuity，BCVA)、黄斑中心凹厚度(central macular thickness，CMT)、眼压(intraocular pressure，IOP)及并发症情况。

结果：两组患者的基线特征相比，差异无统计学意义(P>0.05)。注射组治疗后1、3、6mo BCVA、CMT均明显改善，与治疗前相比，差异均有统计学意义(均P<0.05)； 眼压无明显变化，与治疗前相比，差异均无统计学意义(均P>0.05)。口服组治疗后1、3、6mo BCVA、CMT均无明显改善，与治疗前相比，差异均无统计学意义(均P>0.05)； 眼压无明显变化，与治疗前相比，差异均无统计学意义(均P>0.05)。治疗后1、3、6mo，注射组的BCVA、CMT均明显优于同时间段口服组的BCVA、CMT，差异均有统计学意义(均P<0.05)； 而两组治疗后同时间段的眼压相比，差异均无统计学意义(均P>0.05)。两组治疗后均未见严重的眼部及全身并发症。

结论：玻璃体腔注射1mg的TA在改善全视网膜激光光凝后继发黄斑水肿患者的BCVA、CMT方面明显优于口服羟苯磺酸钙，两种药物治疗后均未引发明显的副作用及严重并发症，治疗安全性较好。

METHODS: A study was performed on the clinical material of 72 patients(72 eyes in total)with macular edema due to panretinal photocoagulation under the treatment in our hospital from Jan. 2012 to Jan. 2015. All of the 72 eyes were underwent treatment with panretinal photocoagulation because of serious diabetic retinopathy. After the treatment of panretinal photocoagulation, the patients got macular edema to varying degree, and some even acquired more serious macular edema than before. Seventy-two eyes were randomly divided into two groups, with respectively 36 eyes in each group: one was the injection group and the other was oral group. The former(patients)were treated with intravitreal injection of triamcinolone acetonide(0.025ml, 1mg); the latter(patients)took orally calcium dobesilate capsule. Best corrected visual acuity(BCVA), central macular thickness(CMT), intraocular pressure(IOP)and complications were observed before the treatment and 1mo, 3mo and 6mo after treatment.

RESULTS: There was not obvious statistical significance on basic characters between two groups(P>0.05). Intra-group comparison: after 1mo, 3mo and 6mo of treatment, BCVA and CMT in the injection group were improved significantly as compared with that before treatment(P<0.05); there were no significant differences in intraocular pressure(P>0.05). After 1mo, 3mo and 6mo of treatment, BCVA and CMT in the oral group showed no statistically significant differences before and after treatment(P>0.05); no differences were found in intraocular pressure(P>0.05). Intergroup comparison: after 1mo, 3mo and 6mo of treatment, BCVA and CMT in the injection group were improved significantly than that in the oral group(P<0.05), but there were no statistical differences in intraocular pressure between the two groups(P>0.05). After treatment, there were not any severe ocular and physical complications in two groups.

CONCLUSION: In terms of improving BCVA and CMT of patients with macular edema due to panretinal photocoagulation, the injection of 1mg intravitreal triamcinolone acetonide is more efficient than oral calcium dobesilate. Both of them are safe and didn't cause any obvious side effects or severe complications.