23G玻璃体切割联合双重多次染色黄斑前膜、内界膜治疗黄斑裂孔性视网膜脱离

发布时间：2018-07-20 08:55

【摘要】：目的研究23 G玻璃体切割联合双重多次染色黄斑前膜、内界膜治疗黄斑裂孔性视网膜脱离的疗效。方法回顾性分析我院确诊的伴黄斑前膜的黄斑裂孔性视网膜脱离患者19例19眼。接受三通道闭合式经睫状体平坦部23 G玻璃体手术。手术在曲安奈德标记、亮蓝染色辅助下23 G玻璃体切割,23 G内界膜镊分层剥离黄斑前膜及内界膜,硅油填充。3个月后取出硅油填充C3F8气体。观察手术时间及术后最佳矫正视力、黄斑裂孔闭合和视网膜脱离复位情况,同时观察术中、术后并发症情况。术后随访6~10(6.0±0.2)个月。结果手术时间60~90 min,平均80 min;黄斑裂孔封闭、视网膜复位率为94.7%;术后最佳矫正视力0.01~0.04者3眼,0.05~0.10者12眼,0.12~0.25者4眼;术中剥离内界膜时部分视网膜点状出血,用笛针吸除大部分出血,必要时行视网膜激光光凝。术后2眼高眼压,予以局部降眼压药物治疗,7~13 d眼压平稳恢复正常。余未见其他术中、术后并发症发生。结论 23 G玻璃体切割联合双重多次染色黄斑前膜、内界膜治疗黄斑裂孔性视网膜脱离取得了较好疗效,不同程度上改善了视力,缩短了手术时间,减少了并发症的发生。
[Abstract]:Objective to study the efficacy of 23 G vitrectomy combined with double multiple staining of macular anterior membrane and internal boundary membrane in the treatment of macular hole retinal detachment. Methods a retrospective analysis of 19 patients with macular retinal detachment with macular retinal detachment with macular membrane in our hospital and 19 eyes received three channel closed pars plana 23 G vitreous surgery was performed. Triamcinolone acetonide marker, bright blue staining assisted 23 G vitreous cutting, 23 G internal boundary membrane tweezers delamination of macular membrane and inner boundary membrane, silicone oil filled with C3F8 gas after.3 months, the operation time and postoperative best corrected visual acuity, macular hole closure and retinal detachment reduction were observed, and postoperative complications were observed. The operation time was 6~10 (6 + 0.2) months after operation. Results the operation time was 60~90 min, average 80 min, macular hole closed, retinal reposition rate was 94.7%; the best corrected visual acuity was 3 eyes, 12 eyes of 0.05~0.10 and 4 eyes of 0.12~0.25, and partial retinal membrane bleed when stripping the inner boundary membrane during the operation, most of the bleeding was sucked out with flute needle and needed to be seen when necessary. Omentum laser photocoagulation. 2 eye pressure after operation, local intraocular pressure (IOP) was treated with local intraocular pressure (IOP) and 7~13 D eye pressure was restored to normal. No other intraoperative complications were seen. Conclusion 23 G vitrectomy combined with double multiple staining of macular membrane, and internal boundary membrane for macular hole optic membrane detachment achieved good effect and improved to different degrees. Eyesight shortens operation time and reduces complications.
【作者单位】：唐山市眼科医院;
【分类号】：R779.6

【参考文献】