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病理性近视患者多次发生黄斑裂孔视网膜脱离，通过额外的眼内硅油注射治疗：病例报告。

Recurrent macular hole retinal detachment in a patient with pathologic myopia treated by additional intravitreal silicone oil injection: A case report.

机构信息

Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Republic of Korea.

出版信息

Medicine (Baltimore). 2021 Apr 9;100(14):e25465. doi: 10.1097/MD.0000000000025465.

DOI:10.1097/MD.0000000000025465
PMID:33832158
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8036109/
Abstract

RATIONALE

Treatment of macular hole retinal detachment (MHRD) in patients with pathologic myopia may require multiple surgeries due to the risk of surgical failures or recurrences. Intravitreal silicone oil injection before an additional surgery may be another option for recurrent MHRD in aphakic eyes, but this procedure is rarely performed.

PATIENT CONCERNS

A 69-year-old man visited the hospital with a chief complaint of metamorphopsia in his right eye for 5 days. The right eye had undergone a cataract extraction 5 years prior and an Nd:YAG laser capsulotomy 1 year prior. The axial length was 36.18 mm; the fundus examination and optical coherence tomography (OCT) revealed inferior retinal detachment with a macular hole involving the posterior pole. Pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling, endolaser photocoagulation, and silicone oil tamponade were performed. Five months after the surgery, the retina was detached, and a macular hole was observed.

DIAGNOSIS

Recurrent MHRD in a patient with pathologic myopia.

INTERVENTION

PPV with ILM peeling, endolaser photocoagulation, and silicone oil tamponade at the initial visit and additional intravitreal silicone oil injection (0.5 ml) at follow-up visits.

OUTCOMES

The retina was well-attached until 5 months after the additional intravitreal silicone oil injection.

LESSONS

Additional intravitreal silicone oil injection can be a good option for treating MHRD in aphakic eyes if the detachment of the retina is dependent on posturing. The surgeon should consider the volume of silicone oil or postoperative posturing in the treatment of MHRD.

摘要

背景

患有病理性近视的患者的黄斑裂孔视网膜脱离（MHRD）的治疗可能需要多次手术，因为存在手术失败或复发的风险。在另一次手术前向玻璃体内注射硅油可能是无晶状体眼复发性 MHRD 的另一种选择，但这种手术很少进行。

患者关注

一名 69 岁男性因右眼视物变形 5 天就诊。右眼 5 年前接受白内障摘除术，1 年前接受 Nd:YAG 激光后囊切开术。眼轴长 36.18mm；眼底检查和光学相干断层扫描（OCT）显示下方视网膜脱离，后极部有黄斑裂孔。行玻璃体切割术（PPV）联合内界膜（ILM）剥离、眼内激光光凝和硅油填充。术后 5 个月，视网膜脱离，观察到黄斑裂孔。

诊断

病理性近视患者复发性 MHRD。

干预措施

初次就诊时行 PPV 联合 ILM 剥离、眼内激光光凝和硅油填充，随访时行额外的玻璃体内硅油注射（0.5ml）。

结果

视网膜在额外的玻璃体内硅油注射后 5 个月内保持在位。

教训

如果视网膜脱离依赖于体位，那么向玻璃体内额外注射硅油可以成为治疗无晶状体眼 MHRD 的一种良好选择。在治疗 MHRD 时，外科医生应考虑硅油的体积或术后体位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c69d/8036109/32e909572bd3/medi-100-e25465-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c69d/8036109/e827c6dc71e7/medi-100-e25465-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c69d/8036109/95fdb9d2e7c9/medi-100-e25465-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c69d/8036109/c7a69653a777/medi-100-e25465-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c69d/8036109/32e909572bd3/medi-100-e25465-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c69d/8036109/e827c6dc71e7/medi-100-e25465-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c69d/8036109/95fdb9d2e7c9/medi-100-e25465-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c69d/8036109/c7a69653a777/medi-100-e25465-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c69d/8036109/32e909572bd3/medi-100-e25465-g004.jpg

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