目的：观察性研究25G微创玻璃体切割联合内界膜剥除治疗严重增殖性糖尿病视网膜病变(PDR)伴黄斑皱褶移位的临床疗效。

方法：收集2016-01/2017-12在江苏省人民医院眼科病房接受玻璃体切割手术的严重PDR伴黄斑皱褶移位的患者36例36眼的临床资料，其中2016-01/12入院的患者18例18眼纳入对照组，行25G微创玻璃体切割术，2017-01/12入院的患者18例18眼纳入联合组，行25G微创玻璃体切割联合内界膜剥除术。观察术前，术后7d，1、3、6mo最佳矫正视力(BCVA)、黄斑中心区厚度(CMT)、眼压及并发症。

结果：术后6mo，两组患者BCVA较术前显著提高(均P<0.05)； 联合组CMT小于对照组(P<0.001)。术后6mo内，联合组中2眼(11%)高眼压、1眼(6%)黄斑水肿； 对照组1眼(6%)高眼压，1眼(6%)黄斑前膜，1眼(6%)玻璃体积血，两组并发症发生率无差异(均P=1.000)。

结论：采用25G微创玻璃体切割联合内界膜剥除术治疗严重PDR伴黄斑皱褶移位能安全有效地提高患者视力及降低黄斑中心区厚度。

METHODS: Clinical data of 36 cases(36 eyes), diagnosed as severe proliferative diabetic retinopathy with macular displacement in Jiangsu Province Hospital were collected. Eighteen cases admitted from January to December 2016 were included in the control group(18 eyes, treated by 25G vitrectomy), while 18 cases admitted from January to December 2017 were included in the combined group(18 eyes, treated by 25G vitrectomy with ILM peeling). Best corrected visual acuity(BCVA), intraocular pressure(IOP), complications, and the thickness of macular center area(CMT)were examined during follow-up at 7d, 1mo, 3mo and 6mo postoperative.

RESULTS: BCVA showed a significant improvement at postoperative 6mo compared with baseline in both groups (P<0.05). CMT of the combination group was thinner than that of the control group(P<0.001). Two eyes(11%)had intraocular hypertension,and 1 eye(6%)had macular edema in the combined group, while post-operative complications included intraocular hypertension(6%),macular membrane(6%)and vitreous hemorrhage(6%)in the control group. No statistical difference was found in the complication rates between the two groups(all P=1.000).

CONCLUSION: In the treatment of severe PDR with macular displacement, 25G vitrectomy combined with ILM peeling can effectively and safely improve visual acuity and reduce the thickness of macular center area.