Gastaud P, Negre F, Leguay J M
Service d'Ophtalmologie, Hôpital Saint-Roch, Nice.
J Fr Ophtalmol. 1997;20(10):741-8.
Maculopathy in diabetes mellitus represents one of the most serious complications of the diabetic retinopathy. Retinal photocoagulations are often impossible and even dangerous. We propose a new method of surgical treatment for this macular serous detachment.
Thirteen eyes from 11 patients were treated using the same surgical procedure: vitrectomy, aspiration of subretinal liquid through a temporal retinotomy, fragmentation and extraction of the sub and intra retinal exsudates through one or several retinotomies, macular massaging with fluorodecaline, endophotocoagulations (focal on vascular anomalies and macular grid) and fluid-gas exchange (C3F8).
Macular serous detachment and subretinal exsudates disappeared in all the cases, the fluorescein leakage decreased. A functional improvement was obtained in 11 eyes, a stabilization in 2.
The clinical results of this new surgical treatment appear to depend on the preoperative macular ischemia and on the age of the detachment. This surgical procedure is very beneficial but could perhaps be technically improved.
糖尿病性黄斑病变是糖尿病视网膜病变最严重的并发症之一。视网膜光凝术常常无法实施，甚至存在危险。我们提出一种针对这种黄斑浆液性脱离的新手术治疗方法。
11例患者的13只眼采用相同的手术步骤进行治疗：玻璃体切除术，通过颞侧视网膜切开术抽吸视网膜下液，通过一个或几个视网膜切开术对视网膜下和视网膜内渗出物进行碎解和提取，用氟代癸烷进行黄斑按摩，眼内光凝（针对血管异常和黄斑格栅进行局部光凝）以及液-气交换（使用C3F8）。
所有病例中黄斑浆液性脱离和视网膜下渗出物均消失，荧光素渗漏减少。11只眼获得功能改善，2只眼病情稳定。
这种新手术治疗的临床效果似乎取决于术前黄斑缺血情况和脱离时间。该手术操作非常有益，但或许在技术上还可改进。
