玻璃体手术治疗眼内晚期视网膜母细胞瘤临床研究

发布时间：2018-04-13 20:25

本文选题：视网膜母细胞瘤 + 玻璃体手术　；参考：《眼科新进展》2014年08期

【摘要】：目的探讨玻璃体手术治疗眼内晚期视网膜母细胞瘤的效果。方法 2012年7月至2013年6月,选择眼内晚期(D期或E期)视网膜母细胞瘤患儿11例(12眼),采用博士伦23G玻璃体切割系统,进行玻璃体视网膜手术,包括玻璃体切割、肿瘤切除、视网膜光凝、眼内填充等。手术后随访6~18个月(平均9.4个月)。结果所有患眼均完成视网膜肿物切除。术后10眼视网膜裂孔封闭、视网膜复位;2眼因肿瘤范围大,视网膜大部分切除。8眼硅油填充,2眼行C3F8填充,2眼未作眼内填充。随访末,病情稳定者8眼,肿瘤复发4眼,眼球摘除1眼,因肿瘤眼外转移去世1例,2眼再行玻璃体内注射马法兰。硅油取出3眼,硅油置换1眼,4眼硅油长期填充。视力保持0.2以上5眼,患儿因年龄小不配合视力检查者7眼。并发白内障2眼,行白内障摘出术。结论玻璃体手术能够有效切除眼内晚期视网膜母细胞瘤,对保留眼球和患眼视力,提高患儿生存率有一定帮助,但其安全性和长期疗效还有待进一步研究。
[Abstract]:Objective to evaluate the effect of vitrectomy in the treatment of advanced retinoblastoma.Methods from July 2012 to June 2013, 11 cases (12 eyes) of retinoblastoma with advanced intraocular retinoblastoma (retinoblastoma) underwent vitrectomy, including vitrectomy and tumor resection, using the doctorum 23G vitrectomy system.Retinal photocoagulation, intraocular filling, etc.All patients were followed up for 6 ~ 18 months (mean 9.4 months).Results Retinectomy was performed in all the affected eyes.After operation, 10 eyes of retinal fissure were closed, 2 eyes of retinal reattachment were enlarged by tumor, 2 eyes were filled with silicone oil in 2 eyes after retinal resection, 2 eyes were filled with C3F8 and 2 eyes were not filled with intraocular.At the end of follow-up, 8 eyes were stable, 4 eyes recurred, 1 eye was enucleated, 1 case died of extraocular metastasis and 2 eyes were treated with intravitreous injection of Mafflane.Silicone oil was removed in 3 eyes, silicone oil was replaced in 1 eye and 4 eyes were filled with silicone oil for a long time.The visual acuity remained above 0.2 in 5 eyes.Cataract extraction was performed in 2 eyes with cataract.Conclusion vitreous surgery can effectively remove advanced retinoblastoma, which is helpful to preserve eyeball and visual acuity and improve survival rate of children, but its safety and long-term curative effect need to be further studied.
【作者单位】：深圳华侨城医院眼科;福建医科大学第二临床医学院;泉州市儿童医院;暨南大学第二临床医学院;深圳市眼科医院;首都医科大学附属北京同仁医院眼科中心;
【基金】：深圳市卫人委项目(编号:201302133)~~
【分类号】：R779.6

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