McDonald H R, Lewis H, Aaberg T M, Abrams G W
Department of Ophthalmology, University of California Medical Center, St. Mary's Hospital and Medical Center, San Francisco.
Ophthalmology. 1989 Mar;96(3):358-63. doi: 10.1016/s0161-6420(89)32902-2.
The authors report nine cases of endodrainage retinotomy site complications that occurred after vitreous surgery for complicated retinal detachments (RDs). Postoperative subretinal neovascularization developed in four eyes at the retinotomy drainage site. In two eyes, postoperative proliferation at a posteriorly placed endodrainage site created traction macular detachments. Redetachment due to retinotomy opening caused by postoperative drainage site proliferation developed in three eyes. The retinas of all nine eyes were eventually reattached, and vision improved from the preoperative level. These complications are related to retinal pigment epithelium and/or Bruch's membrane damage during internal subretinal fluid drainage and retinotomy endolaser photocoagulation. Careful evaluation of extrusion instruments, drainage techniques, retinotomy placement, and subsequent endolaser treatment is necessary to minimize these complications.
作者报告了9例在玻璃体手术治疗复杂性视网膜脱离(RD)后发生的视网膜切开引流部位并发症。4只眼在视网膜切开引流部位出现术后视网膜下新生血管形成。2只眼在后置引流部位出现术后增殖,导致牵引性黄斑脱离。3只眼因术后引流部位增殖导致视网膜切开开口,进而发生视网膜再脱离。所有9只眼的视网膜最终均复位,视力较术前有所改善。这些并发症与视网膜下液内引流及视网膜切开内激光光凝过程中视网膜色素上皮和/或 Bruch 膜损伤有关。为尽量减少这些并发症,必须仔细评估挤压器械、引流技术、视网膜切开位置及后续的内激光治疗。