Aaberg T M
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee.
Am J Ophthalmol. 1988 Nov 15;106(5):519-32. doi: 10.1016/0002-9394(88)90580-6.
Proliferative vitreoretinopathy is a composite of anterior and posterior proliferation producing multidirectional tractional forces and resultant complex management problems. In a series of 98 consecutive cases of nondiabetic, nontraumatic proliferative vitreoretinopathy, anterior proliferation caused retinal detachment in 58 patients. Relaxation of circumferential traction created by anterior proliferation in the vitreous base and its contiguous surfaces is achieved by multiple radial incisions in the vitreous base and associated anterior retina is eliminated by incision of the displaced anterior and posterior hyaloid surfaces. The subsequent release of posterior traction and determination of residual traction by sequential fluid-air exchange before final tamponade with longer acting gas or silicone oil is described. Total retinal reattachment was achieved in 23 of 33 eyes (70%) with only posterior proliferation compared to 27 of 47 eyes (57%) with significant anterior proliferation. Retinal attachment posterior to the scleral buckle was achieved in 27 of 33 eyes (82%) and 37 of 47 eyes (79%), respectively. Although the success rate was less in eyes with anterior proliferation, the retinal reattachment rates in the two groups approached comparability as experience and understanding of the clinical significance increased.
增殖性玻璃体视网膜病变是一种前部和后部增殖的复合体，会产生多方向的牵拉力，并导致复杂的治疗问题。在一系列连续98例非糖尿病、非创伤性增殖性玻璃体视网膜病变病例中，前部增殖导致58例患者发生视网膜脱离。通过在玻璃体基底部进行多个放射状切口来缓解玻璃体基底部及其相邻表面前部增殖所产生的圆周牵拉力，通过切开移位的前部和后部玻璃体后表面来消除相关的前部视网膜。本文描述了随后通过顺序性液气交换释放后部牵拉力并在最终用长效气体或硅油填塞之前确定残余牵拉力的方法。仅存在后部增殖的33只眼中有23只（70%）实现了视网膜完全复位，而存在明显前部增殖的47只眼中有27只（57%）实现了视网膜完全复位。巩膜扣带术后视网膜在后部复位的情况分别为33只眼中的27只（82%）和47只眼中的37只（79%）。尽管存在前部增殖的眼睛成功率较低，但随着经验的积累和对临床意义理解的增加，两组的视网膜复位率接近可比。
