Blumenkranz M, Gardner T, Blankenship G
Arch Ophthalmol. 1986 Feb;104(2):291-6. doi: 10.1001/archopht.1986.01050140149039.
We describe the indications, complications, and results of postvitrectomy fluid-gas exchange and laser photocoagulation for management of complicated vitreoretinal disease. Indications include proliferative vitreoretinopathy, vitreous opacities associated with proliferative diabetic retinopathy, giant retinal tear, recurrent rhegmatogenous retinal detachment, and trauma. Eyes treated with 50% sulfur hexafluoride gas rather than sterile air demonstrated a higher intraocular pressure on the first postexchange day, which was not a significant source of disease. There was no statistically significant difference in retinal reattachment between eyes treated with gas and those treated with air. Fluid-gas exchange in eyes with partial or total retinal detachment resulted in total or partial retinal reattachment, with the macula attached in 82% of cases within the first 48 hours following exchange. Final reattachment rate, with a mean follow-up of 8.9 months (range, six to 36 months), was 55%. In eyes with proliferative vitreoretinopathy, the combination of postoperative argon or krypton laser photocoagulation with fluid-gas exchange was associated with a final reattachment rate of 75%. Postoperative fluid-gas exchange and photocoagulation appear to be safe and effective advances in the treatment of complicated vitreoretinal diseases requiring vitrectomy.
我们描述了玻璃体切除术后液-气交换及激光光凝治疗复杂性玻璃体视网膜疾病的适应证、并发症及治疗结果。适应证包括增殖性玻璃体视网膜病变、与增殖性糖尿病视网膜病变相关的玻璃体混浊、巨大视网膜裂孔、复发性孔源性视网膜脱离及外伤。与使用无菌空气相比，使用50%六氟化硫气体治疗的眼在术后第一天眼压更高，但这并非疾病的重要来源。使用气体治疗的眼与使用空气治疗的眼在视网膜复位方面无统计学显著差异。部分或完全视网膜脱离眼行液-气交换后可实现完全或部分视网膜复位，82%的病例在交换后48小时内黄斑复位。平均随访8.9个月（范围6至36个月），最终复位率为55%。在增殖性玻璃体视网膜病变的眼中，术后氩激光或氪激光光凝联合液-气交换的最终复位率为75%。术后液-气交换及光凝似乎是治疗需要玻璃体切除术的复杂性玻璃体视网膜疾病的安全有效的进展。
