非俯卧位以及大范围内界膜剥除治疗特发性黄斑裂孔疗效观察

发布时间：2018-12-26 12:24

【摘要】：目的探讨大范围内界膜剥除联合体积分数16%全氟丙烷(C3F8)玻璃体腔填充术后不采用俯卧位治疗特发性黄斑裂孔的效果。方法收集我院2010年3月至2013年1月63例(63眼)黄斑裂孔患者,所有特发性黄斑裂孔手术均由同一位手术医师完成,手术采取大范围内界膜剥除、体积分数16%C3F8玻璃体腔填充以及术后不采用俯卧位。手术方式均采用23 G睫状体平坦部玻璃体切割术。缓慢注射吲哚青绿(用50 g·L-1葡萄糖溶液稀释成0.08 g·L-1)染色内界膜约1 min,内界膜剥除至血管弓附近(直径约8000μm),气-液交换,5 min后进行气体与体积分数16%C3F8交换。术后患者保持阅读位3~5 d,随访6个月。结果 63例(63眼)患者中8例8眼为复发性裂孔(12.70%),距离前次手术1~3(1.3±2.1)a;20例(31.75%)2期,21例(33.33%)3期,22例(34.92%)4期。所有裂孔直径为(517.63±258.27)μm,其中4例裂孔直径超过1000μm。术前最佳矫正视力为0.16±0.18,术后为0.27±0.15。单纯裂孔封闭率100%,术中术后未见严重并发症发生。结论大范围内界膜剥除+体积分数16%C3F8玻璃体腔填充及术后非俯卧位治疗特发性黄斑裂孔较以往的玻璃体腔气体填充以及俯卧位的治疗方式更加方便且有效。
[Abstract]:Objective To study the effect of a large-range membrane-stripping combined volume fraction of 16% perfluoropropane (C3F8) in the treatment of idiopathic macular hole without the use of prone position. Methods 63 cases (63 eyes) of macular hole in our hospital from March 2010 to January 2013 were collected. In the operation, 23 G pars plana vitrectomy was used. The membrane was slowly injected with green green (diluted with 50 g 路 L-1 glucose solution to 0.08 g 路 L-1) for about 1 min, and the inner membrane was stripped to the vicinity of the aortic arch (about 8000. mu.m in diameter), and the gas-liquid exchange was performed and the gas was exchanged with the volume fraction of 16% C3F8 after 5 min. The patients were followed up for 3-5 days and followed up for 6 months. Results Among 63 (63 eyes), 8 eyes were recurrent hiatus (12. 70%), 1 to 3 (1. 3, 2.1) a in the previous operation, 20 (31. 75%) in 2, 21 (33. 33%) in 3, and 22 (34. 92%) in 4. The diameter of all the holes was (517,63, 252.27). m u.m, of which 4 cases had a hole diameter of more than 1000. m u.m. The best corrected visual acuity before the operation was 0. 16 and 0. 18, and the operation was 0. 27 to 0. 15. The rate of simple hiatus was 100%, and no serious complications occurred in the operation. Conclusion It is more convenient and effective to treat idiopathic macular hole with large-range membrane stripping + volume fraction of 16% C3F8 glass body cavity filling and post-operative non-prone position for the treatment of idiopathic macular hole.
【作者单位】：浙江大学丽水医院;丽水市中心医院眼科;
【基金】：浙江省中医药科学研究基金资助(编号:2012ZA137)~~
【分类号】：R779.6

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