Han D P, Murphy M L, Mieler W F
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee.
Ophthalmology. 1994 May;101(5):803-8. doi: 10.1016/s0161-6420(94)31255-3.
The visual results and complications were determined for a modified en bloc excision technique for management of diabetic traction macular detachment.
A consecutive series of 30 eyes with this condition underwent pars plana vitrectomy, during which all posterior hyaloid except for portions essential for membrane dissection were excised. Bimanual dissection techniques then allowed excision of fibrovascular membranes "en bloc" with the retained hyaloid.
After 6 to 44 months of follow-up, visual acuity of 5/200 or better was obtained in 23 (77%) of 30 eyes, with complete reattachment in 29 (97%) of 30 eyes. Iatrogenic retinal breaks occurred in 6 (20%) of 30 eyes. Two eyes required repeat vitrectomy.
The modified en bloc excision technique allowed similar visual outcome, a higher reattachment rate, and less postoperative morbidity than previously reported surgical approaches to diabetic traction macular detachment.
确定一种改良整块切除技术治疗糖尿病性牵拉性黄斑脱离的视觉效果和并发症。
连续30例患有该疾病的患眼接受了玻璃体切除术，术中除了保留对膜剥离至关重要的部分外，切除了所有后玻璃体膜。然后采用双手剥离技术，将纤维血管膜与保留的玻璃体膜整块切除。
经过6至44个月的随访，30眼中有23眼（77%）视力达到5/200或更好，30眼中有29眼（97%）完全复位。30眼中有6眼（20%）发生医源性视网膜裂孔。2眼需要再次进行玻璃体切除术。
与先前报道的治疗糖尿病性牵拉性黄斑脱离的手术方法相比，改良整块切除技术能带来相似的视觉效果、更高的复位率以及更低的术后发病率。
