目的探讨增生性糖尿病视网膜病变再次手术的原因和治疗预后。设计回顾性、非对照病例研究。研究对象242例因增生性糖尿病视网膜病变行玻璃体手术的患者。方法回顾性总结2002-2006年因增生性糖尿病视网膜病变接受玻璃体切割术治疗的住院病例,对其中行再次手术病例的原因、出现并发症的时间、再次手术后视力等进行分析。主要指标再次手术原因、视力。结果在入选的242例患者288眼中,32眼接受再次手术,其中24眼再次行玻璃体手术,8眼行巩膜扣带等其他手术治疗。24眼再次行玻璃体手术的原因分别为视网膜脱离13眼(54.2%),玻璃体再出血9眼(37.5%),视网膜脱离合并玻璃体出血1眼(4.2%),黄斑前膜1眼(4.2%)。再次玻璃体手术后视力改善者4眼。基本不变者14眼,下降者6眼。再次与一次玻璃体手术后光感,无光感的发生率经X~2检验,差异有统计学意义(P=0.003)。结论增生性糖尿病视网膜病变再次玻璃体手术的原因主要为视网膜脱离和玻璃体再出血,再次手术后光感/无光感的发生率较高,应重在预防。 Objective To investigate the causes and prognosis of reoperation of proliferative diabetic retinopathy. Design retrospective, uncontrolled case studies. Study of 242 patients with proliferative diabetic retinopathy underwent vitreous surgery patients. Methods Retrospectively summarizes the hospitalized cases of proliferative diabetic retinopathy undergoing vitrectomy from 2002 to 2006, and analyzes the causes of the reoperation cases, the time of complications and the visual acuity after reoperation. The main indicators of surgical reasons, vision. Results Among 288 eyes of 242 patients selected, 32 eyes underwent reoperation. Among them, 24 eyes underwent vitrectomy and 8 eyes underwent other surgical procedures such as scleral buckling. Retrograde vitreous surgery in 24 eyes was performed in 13 eyes (54.2%), 9 eyes (37.5%) with vitreous hemorrhage, 1 eye (4.2%) with vitreous hemorrhage, 1 eye (4.2%) with premacular membrane, . Visual acuity after vitrectomy again 4 eyes. 14 were basically unchanged, descending 6 eyes. Again with a vitreous surgery after light perception, the incidence of light perception by X ~ 2 test, the difference was statistically significant (P = 0.003). Conclusions The main reason of vitreous surgery for proliferative diabetic retinopathy is retinal detachment and rebleeding of vitreous. The incidence of light / non-light sensation after reoperation is higher, and should be given priority to prevention.