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采用25G保留晶状体玻璃体切除术并剥离婴儿家族性渗出性玻璃体视网膜病变周边视网膜晶状体后粘连。

25-gauge lens-sparing vitrectomy with dissection of retrolental adhesions on the peripheral retina for familial exudative vitreoretinopathy in infants.

作者信息

Ma Jin, Hu Yin, Lu Lin, Ding Xiaohu

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, People's Republic of China.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2018 Nov;256(11):2233-2240. doi: 10.1007/s00417-018-4035-4. Epub 2018 Jun 16.

Abstract

BACKGROUND

To evaluate the clinical outcome of 25-gauge lens-sparing vitrectomy with dissection of retrolental adhesions on the peripheral retina for familial exudative vitreoretinopathy in infants.

METHODS

Fifty-one eyes of 39 infants with familial exudative vitreoretinopathy associated with retrolental adhesions on the peripheral retina, retinal fold with macular detachment, and partial lens opacity. A 25-gauge lens-sparing vitrectomy was performed, and retrolental adhesions between the peripheral retina and the posterior lens capsule were surgically dissected. Lens opacification, as assessed or graded by Lens Opacities Classification System III, and the retinal reattachment rate were observed and recorded monthly for up to 7 months postoperatively.

RESULTS

After 7 months, the detached retina along the retinal fold was reattached in 42/51 (82.4%) eyes; the macula was reattached completely in 26/51 (51.0%) eyes and partially in 15/51 (29.4%) eyes. There was no statistically significant change in the lens opacity of the posterior capsule or cortex before or after surgery (P > 0.05, paired t test) or in postoperative progression of lens opacity (P > 0.05, modified McNemar's test) according to Lens Opacities Classification System III scores.

CONCLUSIONS

A 25-gauge lens-sparing vitrectomy with dissection of peripheral retinal retrolental adhesions is helpful for preservation of the lens and reattachment of the macula in infants with FEVR.

摘要

背景

评估25G保留晶状体玻璃体切除术联合周边视网膜晶状体后粘连松解术治疗婴儿家族性渗出性玻璃体视网膜病变的临床疗效。

方法

39例婴儿共51只眼患有家族性渗出性玻璃体视网膜病变,伴有周边视网膜晶状体后粘连、黄斑脱离视网膜皱褶及部分晶状体混浊。行25G保留晶状体玻璃体切除术,手术松解周边视网膜与晶状体后囊膜之间的晶状体后粘连。术后每月观察并记录晶状体混浊情况(采用晶状体混浊分级系统III评估或分级)及视网膜复位率,最长观察7个月。

结果

7个月后,51只眼中42只眼(82.4%)沿视网膜皱褶脱离的视网膜复位;26只眼(51.0%)黄斑完全复位,15只眼(29.4%)黄斑部分复位。根据晶状体混浊分级系统III评分,手术前后晶状体后囊膜或皮质的晶状体混浊情况无统计学显著变化(P>0.05,配对t检验),晶状体混浊术后进展情况也无统计学显著变化(P>0.05,改良McNemar检验)。

结论

25G保留晶状体玻璃体切除术联合周边视网膜晶状体后粘连松解术有助于保留FEVR婴儿的晶状体及黄斑复位。

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