Lee Gwang Hoon, Ahn Jae Kyoun, Park Yeoung Geol
Department of Ophthalmology, Chonnam National University Medical School, 8 Hakdong, Donggu, Gwangju, Korea.
Am J Ophthalmol. 2008 Jun;145(6):1037-1044. doi: 10.1016/j.ajo.2008.01.029. Epub 2008 Apr 18.
To investigate the early postoperative changes in ciliary body after pars plana vitrectomy (PPV) for retinal vascular disease and to determine whether intravitreal triamcinolone acetonide (IVTA) affects postvitrectomy changes of the ciliary body.
Prospective interventional case-control study.
We recruited 46 patients who underwent uncomplicated PPV for retinal vascular disease (35 with proliferative diabetic retinopathy (PDR) and 11 with branch retinal vein occlusion) and divided the patients into two groups according to the use of IVTA at the end of the PPV. The morphologic changes of the anterior segments were measured by ultrasound biomicroscopy (UBM) one day before and one day, two days, three days, five days, two weeks, one month, and two months after the PPV. The main outcome measures were the thickness and area of the ciliary body, the frequency of supraciliary effusions (SEs), angle-opening, and anterior chamber depth (ACD). We compared the UBM parameters between the two groups.
The thickness and area of the ciliary body significantly increased from day 1 to day 5 postoperatively. Nineteen of 46 eyes had SEs that were frequently associated with divergent alterations of postoperative intraocular pressure (IOP). The angle-opening and ACD were significantly decreased and dependent upon the findings of ciliary body thickness and SEs. The degree of the morphologic changes of the ciliary body and the frequency of SEs were significantly lower and of shorter duration in the IVTA group compared to the non-IVTA group.
The PPV for retinal vascular disease induces the morphologic changes of the ciliary body associated with postoperative abnormalities in IOP during the early postoperative period. Administration of IVTA at the end of the PPV effectively reduces or shortens the duration of the postvitrectomy changes of the ciliary body.
研究视网膜血管疾病行玻璃体切割术(PPV)后睫状体的早期术后变化,并确定玻璃体内注射曲安奈德(IVTA)是否会影响玻璃体切割术后睫状体的变化。
前瞻性干预性病例对照研究。
我们招募了46例因视网膜血管疾病接受单纯PPV的患者(35例增殖性糖尿病视网膜病变(PDR)患者和11例视网膜分支静脉阻塞患者),并根据PPV结束时是否使用IVTA将患者分为两组。在PPV术前一天以及术后一天、两天、三天、五天、两周、一个月和两个月,通过超声生物显微镜(UBM)测量眼前节的形态变化。主要观察指标为睫状体的厚度和面积、睫状体上腔积液(SEs)的发生率、房角开放度和前房深度(ACD)。我们比较了两组之间的UBM参数。
术后第1天至第5天,睫状体的厚度和面积显著增加。46只眼中有19只出现SEs,常伴有术后眼压(IOP)的异常变化。房角开放度和ACD显著降低,并取决于睫状体厚度和SEs的情况。与非IVTA组相比,IVTA组睫状体形态变化的程度和SEs的发生率显著更低,且持续时间更短。
视网膜血管疾病行PPV可导致术后早期睫状体形态变化,并伴有IOP异常。在PPV结束时给予IVTA可有效减轻或缩短玻璃体切割术后睫状体的变化持续时间。