眼内C_3F_8气体填充状态下视网膜裂孔的激光治疗  

Laser photocoagulation for retinal breaks under the condition of C_3F_8 tamponade

作　　者：苏兆安[1] 林季建[1] 姜节凯[1] 翁燕[1] 谢欣[1] 

机构地区：[1]浙江大学医学院附属二院眼科中心,浙江杭州310009

出　　处：《眼外伤职业眼病杂志》2006年第8期592-593,共2页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的观察眼内C3F8气体填充状态下视网膜裂孔激光治疗的疗效。方法30例(30眼)视网膜玻璃体手术C3F8填充眼,术后观察封闭不良的原裂孔及新裂孔进行裂隙灯显微镜下激光光凝,术后1周内进行光凝者9例,2～3周后进行光凝者21例。激光参数:氪黄/氪绿,光斑100～200μm,时间0.2～0.3s,功率200～400mW,光凝裂孔3～4排,达到灰白色光凝斑。光凝1次者20例,2次者6例,3次者4例,光凝后随访4～20周,观察光斑色素、裂孔封闭及视网膜复位情况。结果本组30例中有25例裂孔封闭且气体消退后视网膜复位,占83.33%。3例因裂孔处有牵拉裂孔不能闭合、2例因眼内增生性病变引起非裂孔处视网膜脱离,该5例再次玻切手术并注硅油,4例视网膜复位。并发症主要为光凝过度引起的网膜出血2例,均自行吸收。结论眼内C3F8气体填充状态下视网膜裂孔的早期激光治疗能取得良好效果。Objective To evaluate the effects of laser photocoagulation treatment in patients with retinal breaks under the circumstance of C3F8 tamponade after vitrectomy. Methods Postoperative progressive retinal breaks in 30 eyes of 30 cases after pars plana vitrectomy （ PPV ） combined with 16% C3F8 tamponade in early-phase were treated by laser photocoagulation under silitlamp. The progressive retinal breaks included new breaks,enlargement of breaks and initial retinal tears closed badly. On the circumstance of gas bubble,9 eyes were performed in 1 week after PPV and 21 eyes in 2 - 3 weeks.Laser parameter：yellow/green kr-laser, laser spot 100 - 200 um, time 0.2 - 0.3 s, power 200 - 400 mw, the laser solidified the tears 3 - 4 row .20 eyes were reeeivered by the laser photocoagulation once time,6 eyes twice and d eyes three times. Results Among 30 eyes of 30 cases,25 eyes were archieved retinal breaks closing （82%） by laser photocoagulation, 5 eyes had to received vitro-retina surgery again and in 4 eyes the retina was successfully reattached.Totat retinal reattachment was achieved in 29 eyes. Conclusions The laser photocoagulation appears to be effective for treatment with retinal breaks under the circumstance of C3F8 tamponade after vitrectomy in earlyphase.

关 键 词：视网膜裂孔 激光凝固术 玻璃体切除术 C3F8气体 

分 类 号：R774.1[医药卫生—眼科] R779.63[医药卫生—临床医学]