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手术取栓后继发的睫状视网膜动脉分支撕脱:处理与预后

Cilioretinal Artery Branch Avulsion Secondary to Surgical Embolectomy: Management and Outcome.

作者信息

Hernandez-Da Mota Sergio E, Garcia-Aguirre Gerardo, Velez-Montoya Raul

机构信息

Retina Department and Ophthalmology Service, Clinica David, Morelia, Michoacan, Mexico.

Department of Ophthalmology, School of Medicine, Michoacan University, Morelia, Michoacan, Mexico.

出版信息

Middle East Afr J Ophthalmol. 2020 Jan 29;26(4):240-242. doi: 10.4103/meajo.MEAJO_36_18. eCollection 2019 Oct-Dec.

Abstract

We report the trans-operative approach and short-term outcome of a patient who suffered a traumatic avulsion of the cilioretinal artery branch during the surgical management of a cilioretinal arterial branch occlusion (CRABO) with intraocular embolectomy. A patient with acute CRABO underwent a pars plana vitrectomy with embolectomy. The blocked artery was incised using 25 gauge vertical scissors, and embolus manipulation was done using microsurgical forceps. During embolus extraction, the occluded cilioretinal artery and its branch were inadvertently avulsed and torn with subsequent intense bleeding. Laser and endodiathermy were used for acute hemostasis. The maneuvers created an unintended retinochoroidal anastomosis. Visual field improvement was noted 3 months after the surgery. In the event of a complicated surgical embolectomy with the avulsion of the artery, the formation of a retinochoroidal anastomosis and reperfusion of the occluded may occur along with the improvement of visual fields in some cases.

摘要

我们报告了1例在对睫状视网膜动脉分支阻塞(CRABO)行眼内栓子切除术的手术治疗过程中发生睫状视网膜动脉分支外伤性撕脱的患者的术中处理方法及短期预后。1例急性CRABO患者接受了玻璃体切割联合栓子切除术。使用25G垂直剪刀切开阻塞的动脉,并用显微镊子进行栓子操作。在栓子取出过程中,不慎撕脱了阻塞的睫状视网膜动脉及其分支,并导致大量出血。使用激光和眼内透热疗法进行急性止血。这些操作意外地形成了视网膜脉络膜吻合。术后3个月视野改善。在动脉撕脱的复杂手术栓子切除术中,在某些情况下可能会形成视网膜脉络膜吻合,阻塞血管再灌注,并伴有视野改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45ab/7034148/d440339a6a69/MEAJO-26-240-g001.jpg

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