全氟萘烷在玻璃体视网膜手术中应用的临床分析  

The clinical study of application ofperfluorodecalin in pars plana vitrectormy

作　　者：关禹博[1] 陈松[1] 李燕[1] 赵秉水[1] 张珑俐[1] 

机构地区：[1]天津市眼科医院,天津医科大学眼科临床学院,天津300020

出　　处：《中国实用眼科杂志》2008年第10期1104-1107,共4页Chinese Journal of Practical Ophthalmology

基　　金：本课题获天津市科技进步三等奖（2006JB-3-159-R2）

摘　　要：目的探讨全氟萘烷（Perfluorodecalin，PFDL）在睫状体扁平部玻璃体切除术（Pars Plana Vitrectormy，PPV）中的独特作用及在眼内长期残留时对眼组织的影响。方法回顾分析在PPV中应用PFDL的临床病例239例239只眼，其中裂孔源性视网膜脱离（retinal detachment，RD）130例，晶状体脱位于玻璃体腔4例，外伤性RD41例，增殖性糖尿病性视网膜病变导致玻璃体出血合并牵拉性RD21例，视网膜静脉栓塞和视网膜静脉周围炎导致玻璃体腔出血合并牵拉性RD27例，陈旧性脉络膜出血1例，急性视网膜坏死合并视网膜脱离2例，眼内炎3例，Coats病合并牵拉裂孔性RD1例，眼内填充硅油合并RD9例。采用PPV，膜剥离，PFDL使用，眼内激光，气液交换，惰性气体及硅油眼内填充。探讨防止PFDL眼内残留的方法，对黄斑裂孔或后极部裂孔采用“气液交换后置换PFDL法”，对巨大裂孔性视网膜脱离采用“PFDL联合部份气液交换法”，对360。视网膜切开采用“逐步使用PFDL法”。结果随访12～15个月，212例212只眼获得随访，视网膜复位181例181只眼，有效率85-37％，术后PFDL残留22只眼，随访期间，角膜、前房及视网膜均未见功能及结构上的改变。结论PFDL可有效地应用于PPV中，提高治疗巨大裂孔性视网膜脱离、外伤性视网膜脱离、眼内填充硅油合并RD等复杂性视网膜脱离的手术成功率，PFDL小滴在眼内长期存留，临床上未观察到明显眼部损害。Objective To investigate the role ofperfluorodecalin （PFDL）in Pars Plana Vitrectormy （PPV）, and influence of remnent of PFDL.Method 239 eyes were reviewed, who had undergone PPV, and PFDL was used in PPV, among them 130 eyes were complicated retinal detachment （RD）,4 eyes were dislocated lens in vitreous,41 eyes were traumatic retinal detachment,21 eyes were proliferative diabetic retinopathy,27 eyes were retina vascular disease uniting tractional retinal detachment, 1 eye was old choroid hemorrhage,2 eyes were acute retinal necrosis syndrome uniting retinal detachment,3 eyes were endophthalmia, 1 eye was Coats disease,9 eyes were RD uniting silicone oil tamponades.PPV involving the peeling of pre-retinal membrane,PFDL injection,endolaser,fluid-air exchange,and inert gas or silicone oil tamponades.Probed the way of avoiding remnent of PFDL in PPV, ＂permutation of PFDL after air-fluid exchange ＂ was used in PPV of macular hole or posterior pole hole, ＂part air-fluid exchange associate with the use of PFDL＂was used in PPV of grand retina tear,＂ PFDL was used step by step ＂in PPV of 3600 retinotomy, Results 212 eyes were followed for 12 - 15mons, retinal attachment was achieved in 181 eyes, the efficiency was 85.37%, Remnent of PFDL were found in 22 eyes, no functional and morphological changes of cornea , anterior chamber and retina were found in follw--up period.Conclution PFDL can be safely and effectively used in PPV,grant retinal tear RD,RD caused by trauma ,and RD uniting silicone oil tamponades can be successfully treated by using PFDL,remnent of PFDL in the anterior chamber and vitreous cavity are well tolerated and do not induce ocular damage.

关 键 词：玻璃体视网膜手术 视网膜脱离 全氟萘烷 

分 类 号：R779.6[医药卫生—眼科] R774.130.5[医药卫生—临床医学]