Dugel P U, Rao N A, Ozler S, Liggett P E, Smith R E
Doheny Eye Institute, Los Angeles 90033.
Ophthalmology. 1992 Oct;99(10):1535-41. doi: 10.1016/s0161-6420(92)31769-5.
To determine the role of pars plana vitrectomy in patients with intraocular inflammation-related cystoid macular edema that is unresponsive to corticosteroids.
Eleven eyes of nine patients underwent a standard three-port pars plana vitrectomy. The primary indication was intraocular inflammation-related cystoid macular edema that was unresponsive to oral, sub-Tenon's, and topical corticosteroids. Preoperative follow-up ranged from 20 months to 144 months (average, 70 months). Postoperative follow-up ranged from 3 months to 108 months (average, 21 months).
Seven eyes (64%) improved 4 or more lines of Snellen visual acuity within 4 weeks. Two eyes (18%) remained unchanged and 2 eyes (18%) worsened. Cystoid macular edema improved by clinical examination and fluorescein angiography in 9 eyes (82%) and by clinical examination alone in 2 eyes (18%). No intraoperative complications were noted. Postoperative complications consisted of cataract formation in 1 eye (9%), glaucoma in 2 eyes (18%), and epiretinal membrane formation in 1 eye (9%).
Pars plana vitrectomy may have a role in the treatment of intraocular inflammation-related cystoid macular edema that fails to respond to corticosteroids. The subgroup of patients who benefit most remains to be identified.
确定玻璃体切除术在对皮质类固醇无反应的眼内炎症相关性黄斑囊样水肿患者中的作用。
9例患者的11只眼接受了标准的三通道玻璃体切除术。主要指征是对口服、球后及局部皮质类固醇无反应的眼内炎症相关性黄斑囊样水肿。术前随访时间为20个月至144个月(平均70个月)。术后随访时间为3个月至108个月(平均21个月)。
7只眼(64%)在4周内Snellen视力提高了4行或更多。2只眼(18%)视力无变化,2只眼(18%)视力恶化。通过临床检查和荧光素血管造影,9只眼(82%)的黄斑囊样水肿得到改善,2只眼(18%)仅通过临床检查水肿得到改善。术中未发现并发症。术后并发症包括1只眼(9%)形成白内障,2只眼(18%)发生青光眼,1只眼(9%)形成视网膜前膜。
玻璃体切除术可能在治疗对皮质类固醇无反应的眼内炎症相关性黄斑囊样水肿中发挥作用。最受益的患者亚组仍有待确定。