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视网膜脱离复发。2. 机制与治疗(作者译)

[Retinal detachment recurrences. 2. Mechanisms and treatment (author's transl)].

作者信息

Girard P, Rouillac A, Bokobza Y, Kohen D, Forest A

出版信息

J Fr Ophtalmol. 1982;5(2):103-7.

PMID:7200499
Abstract

Retinal detachment recurrences are almost always caused by vitreous tractions or vitreo-retinal retractions. Classical methods of prevention: as atraumatic surgery as possible, no superfluous subretinal fluid drainage, prevention of intraocular bleeding during drainage were employed in the series reported but with a 10.5 per cent recurrence rate. Prevention is based on two methods: encircling laser photocoagulation in the postoperative period when possible and if it is not dangerous for the vitreous, and preventive vitrectomy which has the following indications: bullous detachment, important pre or peroperative intraocular bleeding, or presence of clear signs of impending vitreo-retinal retraction. Using the classical therapeutic methods of indentation, the treatment a 50 per cent success rate for of recurrence was obtained. Treatment can be improved by vitrectomy in every case of recurrence, with combined internal retinal contention, preferably by silicone injection, recurrences due to massive vitreo-retinal retraction.

摘要

视网膜脱离复发几乎总是由玻璃体牵引或玻璃体视网膜退缩引起的。经典的预防方法:在报道的系列病例中采用尽可能无创的手术、不进行多余的视网膜下液引流、防止引流过程中眼内出血,但复发率为10.5%。预防基于两种方法:术后尽可能进行环形激光光凝,前提是对玻璃体无危险,以及预防性玻璃体切除术,其适应证如下:大泡性脱离、术前或术中重要的眼内出血,或存在即将发生玻璃体视网膜退缩的明确迹象。采用经典的压陷治疗方法,复发治疗成功率为50%。对于每一例复发病例,通过玻璃体切除术,联合视网膜内固定(最好通过硅酮注射),可改善因大量玻璃体视网膜退缩导致的复发的治疗效果。

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