Vitrectomy for Diabetic Retinopathy

Diabetic retinopathy is a complication of diabetes. A long-term hyperglycemic environment can damage the endothelium of the retinal blood vessels, causing a series of fundus lesions such as microangioma, hard exudation, cotton mottling, neovascularization, vitreous proliferation, and even retinal detachment. Patients with diabetes for more than 10 years begin to develop fundus lesions. However, if the blood glucose control is poor, or patients with insulin-dependent diabetes may have fundus lesions earlier, diabetic patients need to go to the fundus to check the fundus regularly. This surgery is mainly for vitreous surgery after diabetic retinopathy. Treatment of diseases: diabetic retinopathy type 2 diabetes Indication 1. Non-absorbable vitreous hemorrhage. 2. Diabetic proliferative vitreoretinopathy. 3. Traction retinal detachment. Preoperative preparation 1. Check heart, lung and kidney function to understand whether there is diabetes systemic complications. 2. Blood sugar control is in the normal range. For patients with severe diabetes, blood sugar should also be controlled between 6.2 and 8.2 mmol/l. 3. Visual function examination, vitreous hemorrhage opacity can not see the end of the eye b-check. 4. If necessary, perform corneal endothelium and erg examination. 5. Preoperative routine measurement of intraocular pressure, irrigation of lacrimal passages, surgery eye point antibiotic eye drops for more than 3 days. For those who are frail and have more systemic complications, the conjunctival sac culture and drug sensitivity test are necessary. Surgical procedure 1. First the extra-scleral cerclage in the equatorial region or 1~2mm cerclage in front of the equator. 2. Flat three-channel scleral incision. 3. The central turbid and concentrated vitreous body is first removed by silkworm etching. 4. Then use the excavation method to gradually enlarge to the surrounding area, and temporarily retain the posterior membrane of the vitreous. 5. Incision of the posterior membrane of the vitreous, sometimes a large amount of hemosiderin and bloody substances like a mist into the vitreous cavity are seen, which blurs the field of view. 6. Use a single-sucking technique to remove all turbidity until the retina is visible. 7. The opaque vitreous body was removed again, and the non-proliferative vitreous body except the base was removed as much as possible. 8. In the presence of proliferative vitreoretinopathy, the centripetal traction should be released and removed, then the shredded traction and the retinal anterior membrane should be removed. 9. After the retinal recovery activity, fill with inert gas or silicone oil according to the situation. 10. Stitch the scleral incision and the bulbar conjunctiva with a 6-0 line.

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