Chen H, Wang J, Zhang E
Department of Ophthalmology, Beijing Tongren Hospital.
Zhonghua Yan Ke Za Zhi. 1997 Mar;33(2):125-8.
To study the effect of surgical management for giant retinal tear (GRT).
A standard three-point vitrectomy with silicone oil intraocular injection was performed on 41 cases. Of them, scleral buckling was also performed on 35 cases and lensectomy, on 17 cases. The basal vitreous gel and peri-retinal membranes were resected completely in all the cases. Air-fluid exchange, retinal tack or liquid perfluorocarbon were used to unroll and flatten the flap of the GRTs. Cryopexy or endophotocoagulation were applied to close the GRTs.
In the follow-up for 3-39 months (mean 11.6 months), total retinal attachment was achieved in 29 cases, macular retinal attachment in 7 cases, and no retinal attachment in 5 cases. The final visual acuities were 0.01-0.05 in 6 cases, 0.06-0.1 in 17 cases, 0.2-0.5 in 11 cases and 0.6-1.0 in 2 cases.
The key factor of successful operation is to unroll and flatten the flap of GRTs completely. Scleral buckling shows advantages and disadvantages, while appropriate scleral buckling is necessary in GRTs with proliferative vitreo-retinopathy. Postoperative further proliferation is the main factor affecting the long term effect of the treatment.
研究巨大视网膜裂孔（GRT）手术治疗的效果。
对41例患者实施标准的三点式玻璃体切除术并眼内注射硅油。其中35例同时行巩膜扣带术，17例同时行晶状体切除术。所有病例均彻底切除基底部玻璃体凝胶和视网膜周边膜。采用气液交换、视网膜固定术或液态全氟碳化合物使巨大视网膜裂孔的瓣展开并变平。应用冷冻疗法或眼内光凝封闭巨大视网膜裂孔。
随访3 - 39个月（平均11.6个月），29例实现视网膜完全复位，7例黄斑区视网膜复位，5例未实现视网膜复位。最终视力：6例为0.01 - 0.05，17例为0.06 - 0.1，11例为0.2 - 0.5，2例为0.6 - 1.0。
手术成功的关键因素是使巨大视网膜裂孔的瓣完全展开并变平。巩膜扣带术有其利弊，而对于伴有增生性玻璃体视网膜病变的巨大视网膜裂孔，适当的巩膜扣带术是必要的。术后进一步增生是影响治疗长期效果的主要因素。
