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采用玻璃体切除术及术后使用全氟碳化物液体作为短期填塞治疗巨大视网膜裂孔。

Management of giant retinal tears with vitrectomy and perfluorocarbon liquid postoperatively as a short-term tamponade.

作者信息

Mikhail M A, Mangioris G, Best R M, McGimpsey S, Chan W C

机构信息

Vitreoretinal Service, Ophthalmology Department, Royal Victoria Hospital, Belfast, UK.

出版信息

Eye (Lond). 2017 Sep;31(9):1290-1295. doi: 10.1038/eye.2017.157. Epub 2017 Aug 11.

Abstract

PurposeThe purpose of this study was to study outcomes after using perfluorocarbon liquid (PFCL) as a short-term postoperative vitreous substitute in eyes with retinal detachment from giant retinal tears (GRTs).Patients and methodsA retrospective consecutive case series of patients with retinal detachment from GRT, who underwent vitrectomy using PFCL as short-term postoperative retinal tamponade. PFCL was left in the eye for a mean of 6.7 days (range 7-8 days) and then replaced with gas or silicone oil (SO). The anatomical and functional outcomes and postoperative complications are reported.ResultsA total of 30 eyes of 29 patients with a follow-up of 26.8 months (range 9-55 months) were included. GRTs had a mean size of 150° (range 90°-270°) with 46.6% of eyes with a tear of >180°. Intraoperative retinal re-attachment was achieved in all cases. No cases of retinal slippage were recorded. Four eyes (13.3%) had re-detachment and further surgery required. At final review, 27 eyes (90.9%) had attached retinas, while the remaining 9.1% had SO in situ. The visual acuity improved in 70% of eyes with 41% improving at least 2 Snellen lines and 35% with visual acuity of 6/12 or better. Mild anterior uveitis developed in six eyes (20%), which resolved on topical steroids. Glaucoma developed in one eye and was controlled medically.ConclusionOur study supports the safety and efficacy of PFCL as a short-term postoperative tamponade in cases of GRTs. As it reduces retinal slippage, the use of SO as a primary tamponade decreased in significant proportion of cases.

摘要

目的

本研究的目的是探讨在巨大视网膜裂孔(GRT)所致视网膜脱离的眼中使用全氟碳液(PFCL)作为术后短期玻璃体替代物的效果。

患者与方法

对一系列因GRT导致视网膜脱离并接受玻璃体切除术的患者进行回顾性连续病例分析,术中使用PFCL作为术后短期视网膜填塞物。PFCL在眼内平均留存6.7天(范围为7 - 8天),之后用气体或硅油(SO)替代。报告了解剖和功能结局以及术后并发症。

结果

共纳入29例患者的30只眼,随访时间为26.8个月(范围9 - 55个月)。GRT的平均大小为150°(范围90° - 270°),46.6%的眼裂孔大于180°。所有病例术中均实现视网膜复位,未记录到视网膜滑动病例。4只眼(13.3%)发生再脱离,需要进一步手术。在最终复查时,27只眼(90.9%)视网膜复位,其余9.1%眼内有硅油留存。70%的眼视力提高,其中41%至少提高2行Snellen视力表视力,35%视力达到6/12或更好。6只眼(20%)发生轻度前葡萄膜炎,局部使用类固醇后消退。1只眼发生青光眼,药物控制良好。

结论

我们的研究支持PFCL作为GRT病例术后短期填塞物的安全性和有效性。由于它减少了视网膜滑动,在相当比例的病例中,作为主要填塞物的硅油使用减少。

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