玻璃体切除术治疗黄斑裂孔性视网膜脱离
[Vitrectomy for treatment of retinal detachment caused by macular hole].
作者信息
Liu Q, Qiu X
机构信息
Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029.
出版信息
Zhonghua Yan Ke Za Zhi. 1998 Nov;34(6):418-20.
OBJECTIVE
To evaluate the effect of vitrectomy and autoserum for treatment of retinal detachment caused by macular hole.
METHODS
19 eyes with retinal detachment caused by macular hole were treated with gas tamponade (C(3)F(8)). The follow-up periods ranged from 6 to 24 months. In the case whose macular hole failed to heal, removal of the remains of prefoveal membrane and/or scratching at the retinal pigment epithelium (RPE) and placing autoserum for 7 minutes in the macular hole were performed.
RESULTS
Closure of macular hole was obtained in 15 eyes (80%). The postoperative visual acuity was 0.05 - 0.4. Macular hole failed to heal in 4 eyes. In one eye the remains of prefoveal membrane were removed; in another 3 eyes, in the macular hole scratching at the retinal pigment epithelium (RPE) and placing autoserum were performed and C(3)F(8) tamponade was used. Anatomical cure was obtained in all the 4 eyes. The final visual acuity was 0.1 or better.
CONCLUSION
The findings show that removal of prefoveal membrane is imperative. Scratch at RPE with placement of autoserum in the macular hole is effective for the macular hole which has failed to respond to conventional vitrectomy with air tamponade.
目的
评估玻璃体切除术联合自体血清治疗黄斑裂孔性视网膜脱离的效果。
方法
对19例黄斑裂孔性视网膜脱离患者行气体（C₃F₈）填充玻璃体切除术治疗，随访6～24个月。对黄斑裂孔未愈合者，行中心凹前膜残留组织清除和（或）视网膜色素上皮（RPE）刮除，并在黄斑裂孔处注入自体血清7分钟。
结果
15例（80%）黄斑裂孔闭合，术后视力0.05～0.4。4例黄斑裂孔未愈合，其中1例行中心凹前膜残留组织清除，另3例行黄斑裂孔处视网膜色素上皮（RPE）刮除并注入自体血清，同时行C₃F₈填充。4例均获得解剖复位，最终视力均达到或超过0.1。
结论
结果表明，中心凹前膜清除必不可少。黄斑裂孔处视网膜色素上皮（RPE）刮除并注入自体血清，对常规玻璃体切除联合气体填充治疗无效的黄斑裂孔有效。
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