Mieler W F, Will B R, Lewis H, Aaberg T M
Department of Ophthalmology, Eye Institute, Medical College of Wisconsin, Milwaukee 53226.
Ophthalmology. 1988 Jul;95(7):859-64. doi: 10.1016/s0161-6420(88)33095-2.
The natural history of peripheral uveitis may eventually lead to indications for vitreous surgery. Over a 7-year period, a consecutive series of 12 eyes in nine patients with peripheral uveitis underwent vitreous surgery. Indications for surgery included persistent dense vitreous inflammation, vitreous hemorrhage, traction retinal detachment (RD), and epiretinal membrane formation. Patients were followed for an average of 22 months. Six eyes (50%) required further surgery after the development of RD, recurrent vitreous hemorrhage, or cataract formation. The preoperative finding most frequently associated with postoperative complications was the presence of active neovascularization of the vitreous base. Final visual acuity ranged from 20/30 to 20/100 showing an average improvement of 5 Snellen lines. Persistent cystoid macular edema significantly limited visual improvement in five patients. Patients undergoing vitreous surgery for management of peripheral uveitis may show a significant degree of visual improvement though multiple operations may be required. Control of active neovascularization is an important factor in limiting postoperative complications and the need for further surgery.
周边葡萄膜炎的自然病程最终可能导致玻璃体手术的指征。在7年期间,对9例周边葡萄膜炎患者的连续12只眼进行了玻璃体手术。手术指征包括持续的浓密玻璃体炎症、玻璃体出血、牵拉性视网膜脱离(RD)和视网膜前膜形成。患者平均随访22个月。6只眼(50%)在发生视网膜脱离、复发性玻璃体出血或白内障形成后需要进一步手术。术前最常与术后并发症相关的发现是玻璃体基底部存在活动性新生血管。最终视力范围为20/30至20/100,平均提高了5行斯内伦视力表度数。持续性黄斑囊样水肿在5例患者中显著限制了视力改善。尽管可能需要多次手术,但接受玻璃体手术治疗周边葡萄膜炎的患者可能会有显著的视力改善。控制活动性新生血管是限制术后并发症和进一步手术需求的重要因素。