Abrams G W, Williams G A
Am J Ophthalmol. 1987 Mar 15;103(3 Pt 1):302-8.
We treated 16 eyes with diabetic tractional retinal detachment with a new method of surgical dissection whereby diabetic preretinal membranes and adherent posterior hyaloid were excised and removed as a single unit. This method differs from previously reported methods of diabetic membrane dissection by utilizing the posterior hyaloid to lift and immobilize the membrane as the membrane is excised with horizontally cutting scissors. The preservation of the posterior hyaloid facilitates the separation of the membrane from the retina. Fibrovascular proliferation was more completely removed and bleeding was less than with membrane sectioning techniques. The major surgical complication was posterior retinal break (seven eyes), but with near complete relief of traction all breaks were successfully treated with gas tamponade and laser photocoagulation. Thirteen retinas were completely reattached with a minimum follow-up of four months. One eye developed an extramacular tractional retinal detachment, and two eyes developed peripheral (retrolenticular) fibrovascular proliferation. Eleven eyes had 5/200 or better visual acuity.
我们采用一种新的手术剥离方法治疗了16只患有糖尿病性牵引性视网膜脱离的眼睛，该方法是将糖尿病性视网膜前膜和粘连的玻璃体后皮质作为一个整体切除并移除。这种方法与先前报道的糖尿病性膜剥离方法不同，在使用水平切割剪刀切除膜时，利用玻璃体后皮质来提起并固定膜。保留玻璃体后皮质有助于膜与视网膜的分离。与膜切开技术相比，纤维血管增生被更彻底地清除，出血也更少。主要的手术并发症是视网膜后部裂孔（7只眼），但由于牵引几乎完全解除，所有裂孔均通过气体填塞和激光光凝成功治疗。13只视网膜完全复位，最短随访4个月。1只眼发生黄斑外牵引性视网膜脱离，2只眼发生周边（晶状体后）纤维血管增生。11只眼的视力为5/200或更好。
