Yanoff M
Ann Ophthalmol. 1977 Mar;9(3):283-6.
All 100 eyes treated with transconjunctival cryotherapy to seal peripheral retinal breaks had a final vision as good or better than when they were first seen. Three of the 100 eyes developed clinical retinal detachments subsequent to the initial cryotherapy, necessitating scleral buckling procedures; all 3 had a final vision of 6/6 in the involved eye. No other complications occurred. Indications for treating retinal breaks or for not treating, are presented. In general, all symptomatic retinal breaks and asymptomatic ones if in aphakic eyes, when crescentic or linear at the margin of lattice, or if horseshoe, are treated. Other instances in which asymptomatic retinal breaks are treated are the following: (1) eyes on long-term miotics: (2) cases in which a retinal detachment is present in the fellow eye: (3) the break(s) are in an only eye; (4) cataract extraction is being considered; (5) 4 diopters of myopia or greater are present; or (6) subretinal fluid of more than 1 but less than 2 disc diameters in size is noted. Other retinal breaks not associated with subclinical or clinical retinal detachments are placed under observation at periodic intervals.
所有接受经结膜冷冻疗法以封闭周边视网膜裂孔的100只眼,最终视力均与初诊时相同或更好。100只眼中有3只在初次冷冻治疗后发生了临床视网膜脱离,需要进行巩膜扣带术;这3只眼中受累眼的最终视力均为6/6。未发生其他并发症。文中介绍了治疗视网膜裂孔或不治疗的指征。一般来说,所有有症状的视网膜裂孔以及无晶状体眼中的无症状裂孔,若位于格子样变性边缘呈新月形或线形,或为马蹄形,则予以治疗。治疗无症状视网膜裂孔的其他情况如下:(1)长期使用缩瞳剂的眼;(2)对侧眼存在视网膜脱离的病例;(3)裂孔位于单眼;(4)考虑进行白内障摘除术;(5)存在4屈光度或更高的近视;或(6)发现视网膜下液大于1个视盘直径但小于2个视盘直径。其他与亚临床或临床视网膜脱离无关的视网膜裂孔则定期进行观察。