Zheng Yuping, Sun Naixue, Xiong Quanchen, Wang Xiaohua, Quan Yanlong
Department of Ophthalmology, the Second Hospital of Medical College of Xian Jiaotong University, 36 Xiwu Road Xian 710004 China.
Yan Ke Xue Bao. 2005 Sep;21(3):142-6.
To determine whether triamcinolone acetonide (TA ) staining facilitates posterior hyaloid removal in patients undergoing pars plana vitrectomy (PPV) for retinal disease.
A triamcinolone acetonide(TA)-assisted vitrectomy was performed on patients with the following disease: proliferative diabetic retinopathy (5 eyes), central retinal vein occlusion (5 eyes), macuar hole (3 eyes), and epiretinal membrane (2 eyes). Eyes without apparent preoperative posterior vitreous detachment were enrolled in this study. After a core PPV, TA aqueous suspension (40 mg/ml) was injected into the mid vitreous cavity to visualize the posterior hyaloid, thus allowing a complete posterior hyaloid separation and removal. The visual acuity, intraocular pressure (IOP), tamponade, corneal pathology, after-cataract, vitreous hemorrhage, and necessity for reoperation were thereafter examined for at least 3 months after surgery.
In all patients, the vitreous body was clearly seen by means of triamcinolone during surgery, and complete removal of posterior hyaloid was facilitated and confirmed. Retina was attached in 14 of 15 eyes, and vision acuity was improved in 9 of 15 eyes. Two eyes showed transient postoperative IOP elevation, 2 eyes had after cataract formation and l eye had cataract progression. Vitreous hemorrhage occurred in 1 eye. No eye had corneal pathology.
Triamcinolone improved the visibility of the hyaloid and the safety of surgical procedures during PPV. No obvious adverse effect due to toxicity of TA accrued in TA-assisted PPV.
确定曲安奈德(TA)染色是否有助于因视网膜疾病接受玻璃体切割术(PPV)的患者进行后玻璃体膜切除。
对患有以下疾病的患者进行曲安奈德(TA)辅助玻璃体切割术:增殖性糖尿病视网膜病变(5只眼)、视网膜中央静脉阻塞(5只眼)、黄斑裂孔(3只眼)和视网膜前膜(2只眼)。本研究纳入术前无明显后玻璃体脱离的眼睛。在进行核心PPV后,将TA水混悬液(40mg/ml)注入玻璃体腔中部以观察后玻璃体膜,从而实现后玻璃体膜的完全分离和切除。术后至少3个月检查视力、眼压(IOP)、填塞情况、角膜病变、后发性白内障、玻璃体出血以及再次手术的必要性。
在所有患者中,手术期间通过曲安奈德可清晰看到玻璃体,便于并确认后玻璃体膜被完全切除。15只眼中有14只视网膜复位,15只眼中有9只视力提高。2只眼术后出现短暂眼压升高,2只眼形成后发性白内障,1只眼白内障进展。1只眼发生玻璃体出血。无眼出现角膜病变。
曲安奈德提高了PPV期间玻璃体膜的可视性和手术安全性。在TA辅助的PPV中,未因TA的毒性产生明显不良反应。