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玻璃体黄斑牵引综合征的手术结果

Surgical results in the vitreomacular traction syndrome.

作者信息

McDonald H R, Johnson R N, Schatz H

出版信息

Ophthalmology. 1994 Aug;101(8):1397-402; discussion 1403. doi: 10.1016/s0161-6420(94)31158-4.

Abstract

PURPOSE

The vitreomacular traction syndrome is a distinct clinical entity in which partial posterior vitreous detachment is present in combination with persistent macular adherence, causing traction-induced visual deficit. The authors evaluate the results of vitreous surgery for this syndrome.

METHODS

The authors reviewed 20 consecutive eyes that underwent vitrectomy and posterior hyaloid/epiretinal membrane stripping to better define the clinical features, visual results, and complications of surgery for the vitreomacular traction syndrome.

FINDINGS

Eyes were categorized anatomically as having either "classic" vitreomacular traction syndrome (8 [40%] eyes had 360 degrees midperipheral vitreous detachment) or "variable" vitreomacular traction syndrome (12 [60%] eyes had a variety of midperipheral areas of vitreous separation). Release of vitreomacular traction resulted in improvement in vision of two or more lines in 15 (75%) eyes, with 8 (40%) obtaining 20/50 visual acuity or better. All eyes were followed for at least 6 months. Complications of vitreous surgery included progression of nuclear sclerosis (83% of phakic eyes), epiretinal membrane formation (40%), and retinal breaks (20%).

CONCLUSION

The vitreomacular traction syndrome represents a wide spectrum of vitreoretinal anatomic configurations that can produce visual deficit. Vitrectomy surgery to release macular traction may improve visual acuity.

摘要

目的

玻璃体黄斑牵拉综合征是一种独特的临床病症,其特征为部分玻璃体后脱离合并黄斑持续粘连,进而导致牵拉性视力缺损。作者评估了针对该综合征的玻璃体手术效果。

方法

作者回顾了连续20只接受玻璃体切除术及后玻璃体皮质/视网膜前膜剥除术的眼睛,以更好地明确玻璃体黄斑牵拉综合征手术的临床特征、视力结果及并发症。

结果

根据解剖结构,眼睛被分为患有“典型”玻璃体黄斑牵拉综合征(8只眼[40%]有360度中周部玻璃体脱离)或“变异型”玻璃体黄斑牵拉综合征(12只眼[60%]有不同程度的中周部玻璃体分离区域)。解除玻璃体黄斑牵拉后,视力提高两行或更多行的有15只眼(75%),其中8只眼(40%)达到20/50或更好的视力。所有眼睛均随访至少6个月。玻璃体手术的并发症包括核硬化进展(83%的有晶状体眼)、视网膜前膜形成(40%)和视网膜裂孔(20%)。

结论

玻璃体黄斑牵拉综合征代表了一系列可导致视力缺损的玻璃体视网膜解剖结构。解除黄斑牵拉的玻璃体切除术可能改善视力。

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