内界膜剥除联合玻璃体内注射曲安奈德治疗继发性黄斑前膜的疗效观察

发布时间：2018-03-23 14:16

本文选题：玻璃体内注射　切入点：曲安奈德　出处：《眼科新进展》2017年08期

【摘要】：目的观察内界膜剥除联合玻璃体内注射曲安奈德治疗继发性黄斑前膜的疗效。方法回顾性分析我院2011年6月至2015年6月因继发性黄斑前膜需行玻璃体视网膜手术者42例42眼,所有患者均行标准的23 G经睫状体平坦部的三通道玻璃体切割+黄斑前膜剥除+视网膜内界膜剥除+玻璃体内注射曲安奈德术,术后随访3.0~18.0(8.3±2.4)个月,对手术前后最佳矫正视力、黄斑形态及手术并发症等进行观察。结果随访期末,最佳矫正视力提高者30眼,不变者8眼,下降者4眼;术后最佳矫正视力与术前相比,差异有统计学意义(t=3.145,P=0.000)。黄斑中心神经上皮层厚度术前为(315.62±132.12)μm,术后为(233.42±146.32)μm,手术前后相比差异有统计学意义(t=4.322,P=0.000)。术后视网膜少许出血6眼,玻璃体积血1眼,一过性高眼压6眼;3眼周边牵引性小裂孔,激光治疗后,行玻璃体内C_3F_8填充,视网膜在位。结论玻璃体内注射曲安奈德可以加速黄斑水肿消退,降低黄斑前膜复发,促进视功能恢复。视网膜内界膜剥除在继发性黄斑前膜手术中可以松解黄斑区视网膜皱褶,解除对黄斑中心凹的牵引,改善黄斑区局部的代谢,有利于黄斑功能的恢复。
[Abstract]:Objective to observe the efficacy of intravitreal injection of triamcinolone acetonide in the treatment of secondary macular membrane. Methods 42 cases (42 eyes) of secondary macular membrane underwent vitreoretinal surgery in our hospital from June 2011 to June 2015. All patients were treated with standard 23 G triamcinolone acetonide injection through the 3 channels vitrectomy of the flat part of the ciliary body. The best corrected visual acuity was obtained before and after the operation, and the intravitreal injection of triamcinolone acetonide was performed. The postoperative follow-up was 3. 0 卤18. 0 卤2. 4 卤2. 4 months. Results at the end of follow-up, the best corrected visual acuity was improved in 30 eyes, unchanged in 8 eyes and decreased in 4 eyes. The thickness of neuroepithelial layer in central macular area was 315.62 卤132.12 渭 m before operation and 233.42 卤146.32 渭 m after operation. The difference was statistically significant before and after operation. There was little retinal hemorrhage in 6 eyes and vitreous hemorrhage in 1 eye. The intravitreal injection of triamcinolone acetonide could accelerate the regression of macular edema and reduce the recurrence of macular membrane after laser treatment with intravitreal injection of triamcinolone acetonide. To promote the recovery of visual function. In the secondary macular anterior membrane surgery, the retinal fold in the macular area can be loosened, the traction on the fovea of the macular center can be relieved, the local metabolism of the macular area can be improved, and the recovery of the macular function can be facilitated.
【作者单位】：保定市第一中心医院眼科;
【分类号】：R779.6

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