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用于治疗未合并晚期增生性玻璃体视网膜病变的孔源性视网膜脱离的玻璃体切割术。

Pars plana vitrectomy for the treatment of rhegmatogenous retinal detachment uncomplicated by advanced proliferative vitreoretinopathy.

作者信息

Gartry D S, Chignell A H, Franks W A, Wong D

机构信息

Department of Ophthalmology, St Thomas's Hospital, London.

出版信息

Br J Ophthalmol. 1993 Apr;77(4):199-203. doi: 10.1136/bjo.77.4.199.

Abstract

A consecutive series of 114 eyes (112 patients) undergoing pars plana vitrectomy for rhegmatogenous retinal detachment not complicated by severe proliferative vitreoretinopathy is presented (follow up 1 to 4 years; mean 19 months). The indications for vitrectomy fell into two main groups: (1) where the retinal view was poor and vitrectomy was required to clear media opacities to allow identification of retinal breaks (n = 62); and (2) where technically difficult breaks existed and vitrectomy with internal tamponade was used to relieve vitreoretinal traction and facilitate retinal break closure (n = 44). In some of these cases the need for scleral buckling was eliminated. A smaller third group (n = 8) existed where the position of the break(s) was uncertain in the presence of an adequate view. The success rate with one procedure was 74% and with further surgery retinal reattachment was achieved in 92%. At 6 months after further surgery, beyond which interval no new failures were encountered, best corrected visual acuity was improved in 92 eyes (81%), unchanged in 14(12%), and worse in eight (7%). We conclude that pars plana vitrectomy is an effective method for treatment of selected cases of rhegmatogenous retinal detachment not complicated by proliferative vitreoretinopathy.

摘要

本文报告了连续114只眼(112例患者)因孔源性视网膜脱离接受玻璃体切割术,且未合并严重增生性玻璃体视网膜病变(随访1至4年,平均19个月)。玻璃体切割术的适应证主要分为两组:(1)视网膜视野不佳,需要进行玻璃体切割术以清除介质混浊,以便识别视网膜裂孔(n = 62);(2)存在技术上难以处理的裂孔,采用玻璃体切割术联合眼内填充以缓解玻璃体视网膜牵拉并促进视网膜裂孔闭合(n = 44)。在其中一些病例中,无需进行巩膜扣带术。还有一小部分第三组病例(n = 8),在视野良好的情况下裂孔位置不确定。一次手术的成功率为74%,再次手术后视网膜复位率达到92%。在再次手术后6个月(此后未再出现新的失败病例),92只眼(81%)的最佳矫正视力得到改善,14只眼(12%)视力不变,8只眼(7%)视力下降。我们得出结论,玻璃体切割术是治疗未合并增生性玻璃体视网膜病变的特定孔源性视网膜脱离病例的有效方法。

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