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[视网膜脱离手术的新进展]

[New developments in retinal detachment surgery].

作者信息

Bartz-Schmidt U, Szurman P, Wong D, Kirchhof B

机构信息

Universitäts-Augenklinik Tübingen, Tübingen, Deutschland.

出版信息

Ophthalmologe. 2008 Jan;105(1):27-36. doi: 10.1007/s00347-007-1662-2.

Abstract

The initial surgery is one of the most important factors influencing the anatomic and functional outcome of retinal detachment surgery. With the continual modifications in vitrectomy techniques, the strategy in primary vitrectomy surgery is also changing. Recent developments are the use of 25- and 23-gauge trocar systems and new surgical techniques without the use of perfluorcarbons or gas or silicone oil tamponade. In addition, heavy silicone oils are now entering routine clinical use, especially for proliferative vitreoretinopathy (PVR) redetachments of the lower fundus periphery. Regarding adjunct pharmacologic therapy, daunorubicin and 5-fluorouracil/low molecular weight heparin have been found to improve the results of patients with PVR or at risk for PVR.

摘要

初始手术是影响视网膜脱离手术解剖和功能结果的最重要因素之一。随着玻璃体切除术技术的不断改进,原发性玻璃体切除手术的策略也在发生变化。最近的进展包括使用25G和23G套管系统以及不使用全氟碳、气体或硅油填塞的新手术技术。此外,重硅油目前正在进入常规临床应用,特别是用于眼底周边下部的增生性玻璃体视网膜病变(PVR)再脱离。关于辅助药物治疗,已发现柔红霉素和5-氟尿嘧啶/低分子量肝素可改善PVR患者或有PVR风险患者的治疗效果。

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