Hung Jia-Horung, Rao Narsing A, Chiu Wei-Chun, Sheu Shwu-Jiuan
Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Graefes Arch Clin Exp Ophthalmol. 2023 Apr;261(4):913-923. doi: 10.1007/s00417-022-05862-9. Epub 2022 Oct 12.
This study aims to conduct a narrative review about the current role of vitreoretinal surgery in the management of infectious and non-infectious uveitis.
This review was performed based on a search of the PubMed database or on relevant published papers according to our current knowledge.
A total of 91 articles were identified in the literature review. With the advance of microincision vitrectomy surgery (MIVS), pars plana vitrectomy (PPV) has gained increasing popularity in the management of infectious and non-infectious uveitis. For diagnostic purposes, larger amounts of sample can be obtained by MIVS than traditional vitreous aspiration using needles. For treatment purposes, PPV removes vitreous opacities, decreases inflammatory cytokines and mediators of inflammation, and tackles related complications, including hypotony, epiretinal membrane, macular holes, and retinal detachment. Achieving optimum control of inflammation prior to surgery is important for surgical interventions for non-emergent therapeutic indications and complications of uveitis. Peri-operative inflammation management is essential for decreasing the risk of surgical intervention. An overall complication rate of 42-54% was reported with cataract to be the leading cause of complications.
Most reports affirm the role of PPV in the management of infectious and non-infectious uveitis, although the quality of data remains limited by a lack of applying standardized reporting outcomes, limitations in study design, and a paucity of prospective data.
本研究旨在对玻璃体视网膜手术在感染性和非感染性葡萄膜炎治疗中的当前作用进行叙述性综述。
本综述基于对PubMed数据库的检索或根据我们目前的知识对相关已发表论文进行。
在文献综述中总共确定了91篇文章。随着微切口玻璃体切除术（MIVS）的发展，玻璃体切除术（PPV）在感染性和非感染性葡萄膜炎的治疗中越来越受欢迎。出于诊断目的，与传统的针吸玻璃体术相比，MIVS可以获得更多的样本。出于治疗目的，PPV可清除玻璃体混浊，减少炎症细胞因子和炎症介质，并处理相关并发症，包括低眼压、视网膜前膜、黄斑裂孔和视网膜脱离。对于非紧急治疗适应症和葡萄膜炎并发症的手术干预，在手术前实现炎症的最佳控制很重要。围手术期炎症管理对于降低手术干预风险至关重要。据报道，总体并发症发生率为42%-54%，白内障是并发症的主要原因。
大多数报告肯定了PPV在感染性和非感染性葡萄膜炎治疗中的作用，尽管由于缺乏标准化报告结果、研究设计的局限性和前瞻性数据的匮乏，数据质量仍然有限。
