激光脉络膜视网膜静脉吻合术的远期疗效和并发症观察  

Long-term efficacy and complications of laser chorioretinal venous anastomosis

作　　者：李毓敏[1] 何晓健[1] 韩萍[1] 王竞[1] 莫建锋[1] 冯琦蓉[1] 

机构地区：[1]浙江大学医学院第一附属医院眼科中心,杭州310003

出　　处：《眼科研究》2004年第5期508-511,共4页Chinese Ophthalmic Research

基　　金：浙江省医药卫生科学研究基金资助 (2 0 0 0A0 93)

摘　　要：目的　评价激光脉络膜视网膜静脉吻合 (CRVA )术后≥ 2年的视网膜静脉阻塞患者的疗效和并发症。方法　选择 2 0例 2 0眼 ,术后 2个月和末次随访 2个时间点 ,观察吻合功能、视力、眼底、荧光血管造影及吻合点并发症。结果　吻合成功 11眼 ( 11/2 0 ,5 5 % ) 16点 ( 16/4 8,3 3 3 % ) ,吻合未成功 9眼 ( 9/2 0 ,45 % ) ,两次随访结果一致。视力 :吻合成功组提高 7例 ,不变 4例 ;未成功组提高 1例 ,不变 3例 ,下降 5例 (P <0 0 5〉。吻合点远期并发症包括脉络膜视网膜新生血管5处 ( 5 /4 8,10 4% ) ,视网膜前纤维膜 5处 ( 5 /4 8,10 4% ) ,视网膜前出血 1处 ( 1/4 8,2 1% )。结论　激光CRVA术可有效建立脉络膜视网膜静脉吻合 ,改善视力 ,吻合疗效持久 ;Objective To evaluate the long-term efficacy and complication of laser chorioretinal venous anastomosis(CRVA)for retinal vein occlusion(RVO). Methods Twenty eyes with RVO received CRVA and were followed-up over 2 years.The function of anastomosis,visual acuity,the changes of eyeground or fundus fluorescein angiogram and long-term complications of anastomostic site were observed. Results Successful chorioretinal venous anastomosis were achieved in 16 sites(16/48,33.3%)of 11 eyes(11/20,55%),and was unsuccessful in 9 of 20 eyes (9/20,45%) with the completely consistent outcome in follow-up.In the successful anastomosis group,visual acuity was improved in 7 eyes and unchanged in 4 eyes,and in the unsuccessful anastomosis group, visual acuity increased in 1 eye,decreased in 5 eyes and remined unchanged in 3 eyes(P<0.05).Long-term complications of anastomostic site included 5 sites (5/48,10.4%) of neovascular membrane,5 sites (5/48,10.4%) of avacular fibrous tissue proliferation and 1 site (1/48,2.1%) of preretinal hemorrhage. Conclusion Laser CRVA can effectively establish a chorioretinal veinous anastomosing for a long period.It is necessary to monitor the long-term complications closely.

关 键 词：脉络膜视网膜静脉吻合 激光 视网膜静脉阻塞 治疗 重建视网膜静脉循环 

分 类 号：R779.63[医药卫生—眼科]