Okada K, Sakata H, Mizote H, Minamoto A, Narai A, Choshi K
Department of Ophthalmology, Hiroshima University School of Medicine, Japan.
Retina. 1997;17(2):99-104. doi: 10.1097/00006982-199703000-00003.
Although retinal breaks occur frequently during vitrectomy, the postoperative occurrence of new retinal holes close to the vascular arcade after vitrectomy for rhegmatogenous retinal detachment rarely has been reported.
Three patients with rhegmatogenous, retinal detachment were treated by vitrectomy. More than 49 days after vitrectomy, posterior retinal holes with no retinal detachment occurred halfway between the vascular arcade and the chorioretinal scar around the extrusion hole or the primary retinal tear.
These new holes were effectively managed with photocoagulation.
New hole formation could be caused by the technique of the internal drainage, the contraction of the photocoagulation scar, or epiretinal membrane contraction. Another possibility is that new holes occur through two opposite tangential traction contractile forces: one induced by the contraction of the photocoagulation scar, the other caused by the contraction of the premacular cortical vitreous attached to the vascular arcade.
尽管视网膜裂孔在玻璃体切除术中频繁出现，但关于孔源性视网膜脱离玻璃体切除术后靠近血管弓处新出现视网膜裂孔的术后情况鲜有报道。
对3例孔源性视网膜脱离患者行玻璃体切除术。玻璃体切除术后49天以上，在血管弓与挤压孔或原发性视网膜裂孔周围脉络膜视网膜瘢痕之间的中点处出现无视网膜脱离的视网膜后裂孔。
这些新裂孔通过光凝得到有效处理。
新裂孔形成可能是由内引流技术、光凝瘢痕收缩或视网膜前膜收缩引起的。另一种可能性是新裂孔通过两种相反的切线牵拉力形成：一种由光凝瘢痕收缩引起，另一种由附着于血管弓的黄斑前皮质玻璃体收缩引起。
