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糖尿病性视网膜病变玻璃体切除术后的玻璃体积血

Vitreous hemorrhage after vitrectomy for diabetic retinopathy.

作者信息

Novak M A, Rice T A, Michels R G, Auer C

出版信息

Ophthalmology. 1984 Dec;91(12):1485-9. doi: 10.1016/s0161-6420(84)34099-4.

Abstract

The records of 596 consecutive vitrectomy cases performed for complications of diabetic retinopathy were reviewed to determine the incidence of intraoperative and postoperative vitreous hemorrhage and to determine if blood cleared more rapidly in aphakic compared to phakic eyes. Uncontrollable intraocular bleeding occurred in two eyes (0.5%). Vitreous hemorrhage was present on the first postoperative day in 278 eyes (63%). This early hemorrhage cleared in an average of 9.1 weeks in phakic eyes and 3.4 weeks in aphakic eyes. Further vitreous hemorrhage occurred in 88 eyes (23%). Sixty-four percent of later hemorrhages occurred in 88 eyes (23%). Sixty-four percent of later hemorrhages occurred within six months of the operation and 80% occurred within one year. Later vitreous hemorrhage cleared in an average of 16.2 weeks in phakic eyes and 5.3 weeks in aphakic eyes. Of the 311 eyes with vitreous hemorrhage at some time during the postoperative course, twenty-nine eyes (9%) underwent reoperation to remove nonclearing blood. Nonclearing vitreous hemorrhage was the main cause of final visual loss in only 15 (3.4%) of 438 eyes with adequate follow-up, and 6 of these 15 eyes had final vision of 5/200 or better.

摘要

回顾了596例因糖尿病视网膜病变并发症而连续进行玻璃体切除术的病例记录,以确定术中及术后玻璃体出血的发生率,并确定与有晶状体眼相比,无晶状体眼的血液清除是否更快。2只眼(0.5%)发生了无法控制的眼内出血。278只眼(63%)在术后第一天出现玻璃体出血。这种早期出血在有晶状体眼中平均9.1周清除,在无晶状体眼中平均3.4周清除。88只眼(23%)发生了进一步的玻璃体出血。64%的后期出血发生在88只眼(23%)。64%的后期出血发生在术后6个月内,80%发生在1年内。后期玻璃体出血在有晶状体眼中平均16.2周清除,在无晶状体眼中平均5.3周清除。在术后过程中某个时间发生玻璃体出血的311只眼中,29只眼(9%)接受了再次手术以清除未清除的血液。在438只接受充分随访的眼中,未清除的玻璃体出血仅是15只眼(3.4%)最终视力丧失的主要原因,这15只眼中有6只眼的最终视力为5/200或更好。

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