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使用全氟碳液体进行短期术后填塞的玻璃体切除术治疗巨大视网膜裂孔

Vitrectomy with short term postoperative tamponade using perfluorocarbon liquid for giant retinal tears.

作者信息

Sirimaharaj M, Balachandran C, Chan W C, Hunyor A P, Chang A A, Gregory-Roberts J, Hunyor A B, Playfair T J

机构信息

Vitreoretinal Unit, Sydney Hospital and Sydney Eye Hospital, Australia.

出版信息

Br J Ophthalmol. 2005 Sep;89(9):1176-9. doi: 10.1136/bjo.2004.065409.

Abstract

AIM

To determine the efficacy and safety of perfluorocarbon liquid as a short term postoperative tamponade in patients with retinal detachment from giant retinal tears.

METHOD

A retrospective consecutive case series of patients with retinal detachment from giant retinal tears who underwent vitrectomy using perfluorocarbon liquid as a short term postoperative internal tamponade. The perfluorocarbon liquid was removed 5-14 days (mean 7.5 days) later and replaced by gas or silicone oil. Scleral buckling was performed in some cases with proliferative vitreoretinopathy. The crystalline lens was removed if there was interference with the surgical view or if it was subluxated. The success rate of retinal reattachment, visual outcome, and postoperative complications were assessed.

RESULTS

A total of 62 eyes of 61 patients with a follow up of 8-69 months (mean 24.5 months) were included. All retinas were attached intraoperatively. 14 eyes (22.6%) developed re-detachment and additional operations were performed in 13 eyes. At final visit, 58 eyes (93.5%) had retinas that remained attached with visual acuity 6/12 or better in 27 eyes (46.5%). The visual acuity improved in 34 eyes (54.8%) with 28 eyes (45.2%) improving at least two Snellen lines, it was unchanged in 20 eyes (32.3%), and was worse in eight eyes (12.9%). Three patients developed glaucoma that was controlled medically. There was no retained perfluorocarbon liquid in any eyes.

CONCLUSION

Perfluorocarbon liquid appears safe and effective to use as a short term postoperative tamponade in management of retinal detachment from giant retinal tears.

摘要

目的

确定全氟碳液体作为巨大视网膜裂孔性视网膜脱离患者术后短期填塞物的有效性和安全性。

方法

对一系列连续的巨大视网膜裂孔性视网膜脱离患者进行回顾性研究,这些患者接受了玻璃体切除术,术中使用全氟碳液体作为术后短期眼内填塞物。术后5 - 14天(平均7.5天)取出全氟碳液体,代之以气体或硅油。部分患有增殖性玻璃体视网膜病变的患者同时进行了巩膜扣带术。如果晶状体干扰手术视野或晶状体半脱位,则将其摘除。评估视网膜复位成功率、视力结果及术后并发症。

结果

纳入61例患者的62只眼,随访8 - 69个月(平均24.5个月)。所有视网膜在术中均已复位。14只眼(22.6%)发生再脱离,其中13只眼进行了二次手术。末次随访时,58只眼(93.5%)视网膜保持复位,27只眼(46.5%)视力达到6/12或更好。34只眼(54.8%)视力提高,其中28只眼(45.2%)至少提高两行视力表读数;20只眼(32.3%)视力无变化;8只眼(12.9%)视力下降。3例患者发生青光眼,经药物治疗得到控制。所有眼均无全氟碳液体残留。

结论

全氟碳液体作为巨大视网膜裂孔性视网膜脱离术后短期填塞物似乎安全有效。

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