Quiroz-Mercado H, Garza-Karren C D, Roigmelo E A, Jimenez-Sierra J M, Dalma-Weiszhausz J
Servicio de Retina, Asociación Para Evitar la Ceguera en México, Hospital, Dr. Luis Sánchez Bulnes, San Lucas Coyoacan, México.
Eur J Ophthalmol. 1997 Jan-Mar;7(1):101-4. doi: 10.1177/112067219700700117.
To establish whether total vitrectomy with posterior hyaloid removal and choroidal hemorrhage drainage posterior sclerotomies improved the outcome of eyes with massive postoperative suprachoroidal hemorrhage (kissing choroidals).
We reviewed the medical records of five patients with massive suprachoroidal hemorrhage (MSCH) who had received the same medical and surgical management.
Three eyes had MSCH secondary to surgery of the anterior segment and two after ocular trauma. All had hemorrhagic choroidal detachment with retinal apposition, producing vitreous changes and adherence of the "kissing" retina. Surgery was delayed one to three weeks to allow liquefaction of the blood clot. All eyes had complete ocular evaluation including ultrasound, and were treated with steroids before surgical treatment. The procedure consisted of anterior chamber fluid infusion, posterior drainage sclerotomies, and primary total pars plana vitrectomy with posterior hyaloid removal. Mean follow-up was 9.4 months. Visual acuity after surgery improved in all eyes from light perception to 20/60. One patient without light perception improved to 20/200.
Total vitrectomy may be indicated in selected cases with MSCH. The successful outcome of these patients comes from the combination of vitrectomy and external drainage.
确定行玻璃体全切除术联合去除后玻璃体膜及脉络膜出血引流巩膜后切开术是否能改善发生大量术后脉络膜上腔出血（脉络膜“相贴”）患者的预后。
我们回顾了5例接受相同药物及手术治疗的大量脉络膜上腔出血（MSCH）患者的病历。
3只眼的MSCH继发于前段手术，2只眼继发于眼外伤。所有患者均出现出血性脉络膜脱离伴视网膜贴附，导致玻璃体改变及“相贴”视网膜粘连。手术推迟1至3周以使血凝块液化。所有患眼均接受了包括超声在内的全面眼部评估，并在手术治疗前使用了类固醇。手术步骤包括前房注液、巩膜后引流切开术以及一期玻璃体全切除联合去除后玻璃体膜。平均随访时间为9.4个月。术后所有患眼的视力均从光感提高到了20/60。1例无光感患者的视力提高到了20/200。
在部分MSCH病例中可考虑行玻璃体全切除术。这些患者的良好预后源于玻璃体切除术与外部引流的联合应用。
