Vidaurri-Leal J, de Bustros S, Michels R G
Am J Ophthalmol. 1984 Oct 15;98(4):463-6. doi: 10.1016/0002-9394(84)90132-6.
We treated 23 consecutive cases of giant retinal tears with inverted retinal flaps. We used pars plana vitrectomy together with an intravitreal bubble to unfold the posterior retinal flap, combined with cryotherapy to cause a chorioretinal adhesion and a broad scleral buckle. The vitrectomy was done after applying cryotherapy so viable retinal pigment epithelial cells in the vitreous cavity could also be removed. Thirteen eyes had giant tears measuring 90 to 180 degrees (Group 1), eight eyes had giant tears measuring 180 to 270 degrees (Group 2), and two eyes had giant tears larger than 270 degrees (Group 3). The retina was successfully reattached in 11 of the 13 eyes in Group 1, each of the eight eyes in Group 2, and one of the two eyes in Group 3. We believe that vitrectomy and lavage of the vitreous cavity after applying cryotherapy was important in reducing the incidence of proliferative vitreoretinopathy and improving our success rate.
我们连续治疗了23例伴有视网膜瓣反转的巨大视网膜裂孔患者。我们采用了经平坦部玻璃体切除术联合玻璃体内气泡来展开后部视网膜瓣，并结合冷冻疗法以形成脉络膜视网膜粘连和广泛的巩膜扣带术。冷冻疗法应用后进行玻璃体切除术，这样玻璃体腔内存活的视网膜色素上皮细胞也能被清除。13只眼中有巨大裂孔，范围为90至180度（第1组），8只眼中有巨大裂孔，范围为180至270度（第2组），2只眼中有大于270度的巨大裂孔（第3组）。第1组13只眼中的11只、第2组8只眼中的每一只以及第3组2只眼中的1只视网膜成功复位。我们认为，冷冻疗法应用后进行玻璃体切除术及玻璃体腔灌洗对于降低增殖性玻璃体视网膜病变的发生率和提高成功率至关重要。
