玻璃体手术治疗特发性黄斑前膜并发医原性视网膜裂孔的临床分析  

Analysis of iatrogenic retinal breaks compficating pars plana vitrectomy in eyes with idiopathic macular pucker

作　　者：樊文英[1] 徐军[1] 马凯[1] 侯志嘉[1] 翁乃清[1] 刘宁朴[1] 

机构地区：[1]首都医科大学附属北京同仁医院眼科中心,100730

出　　处：《眼科》2008年第4期258-261,共4页Ophthalmology in China

摘　　要：目的探讨玻璃体手术治疗特发性黄斑前膜并发医原性视网膜裂孔的发生率、危险因素、临床特点和治疗预后。设计回顾性病例系列。研究对象行玻璃体手术治疗的特发性黄斑前膜患者84例88眼。方法记录并分析玻璃体手术中或手术后发现医原性视网膜裂孔的病例。主要指标术中或术后出现裂孔的发生率、部位、数量、治疗方法和视网膜复位率。结果88眼中共有8眼出现了14个医原性视网膜裂孔,总发生率为9.1%。周边裂孔的发生率(8.0%)高于后极部裂孔(1.1%)。13个周边裂孔均分布在有巩膜切口的象限(100%),并以术者主操作手一侧为主(62%)。多数裂孔于手术中发现(88%)。最终8眼视网膜全部复位(100%)。结论医原性视网膜裂孔是目前条件下玻璃体手术治疗特发性黄斑前膜的重要并发症之一,周边视网膜裂孔的发生率高于后极部裂孔。周边裂孔的发生主要与巩膜切口相关。Objective To determine the incidence and risk factors of iatrogenic retinal breaks in eyes undergoing pars plana vitrectomy for idiopathic macular pucker. Design Retrospective case series. Participant 88 consecutive vitrectomies performed on eyes with idiopathic macular pucker. Method Consecutive vitrectomies performed on eyes with idiopathic macular pucker at Beijing Tongren Eye Center between 2002 and 2006 were retrospectively reviewed. Cases with iatrogenic retinal breaks were recorded and analyzed. Main Outcome Measure Number and location of retinal breaks, and anatomic outcome after surgical managements. Result A total of 88 consecutive vitrectomies were included in the study. Of the 88 eyes, 8 eyes had 14 iatrogenic retinal breaks detected, with an average incidence of 9.1%. Peripheral retinal breaks （8.0%） were more common than posterior retinal breaks （1.1%）. All peripheral retinal breaks occurred around the sclerotomy sites （100%） and the quadrant of predominant hand was involved most commonly （62%）. Most of the breaks （88%） were detected during the surgery. All eyes with iatrogenic retinal breaks obtained anatomic retinal reattachment （100%）. Conclusion Despite improvements in instrumentation and surgical techniques, iatrogenic retinal break continues to be an important complication of pars plana vitrectomy in eyes with idiopathic macular pucker. This complication tends to occur more commonly at peripheral retina and is mainly sclerotomy-related.

关 键 词：特发性黄斑前膜 玻璃体切割术/并发症 医原性视网膜裂孔 

分 类 号：R779.6[医药卫生—眼科]