玻璃体切割术治疗急性视网膜坏死综合征手术时机探讨  

Choice of opportune moment for acute retinal necrosis syndrome by vitrectomy

作　　者：金绘祥[1] 黄宝玲[1] 吴昌凡[1] 赵海峰[1] 郎平[1] 梅立新[1] 

机构地区：[1]皖南医学院弋矶山医院眼科,安徽芜湖241001

出　　处：《临床眼科杂志》2013年第3期233-235,共3页Journal of Clinical Ophthalmology

摘　　要：目的探讨不同时机的玻璃体切割术对急性视网膜坏死综合征(ARNs)视力预后的影响。方法对2009年9月至2011年10月我院收治的ARNs患者5例(7只眼)的进行回顾性分析,年龄47～63岁,平均(55.2±6.5)岁,男女比例3:2。术前已明确伴有视网膜脱离2例(2只眼)接受玻璃体切割联合晶状体切割及硅油填充术。抗病毒药物治疗后3例(3只眼)眼部体征加重,未发生视网膜脱离2例(2只眼)接受预防性玻璃体切割术,另1例(1只眼)玻璃体切割术中发现有视网膜脱离,联合硅油填充术。后发作的2例(2只眼)接受抗病毒药物治疗及外路视网膜光凝。结果术后随访6个月至2年,硅油填充3只眼半年左右均行硅油取出术,视力无改善或下降,有1只眼视网膜脱离复发。预防性玻璃体切割术2只眼及后发作的2只眼视网膜均保持附着,视力恢复均超过治疗前。结论 ARNs经抗病毒药物治疗后若眼部体征仍加重,早期预防性玻璃体切割术可以避免视网膜脱离的发生,视力预后更好。Objective To analyze visual outcome in acute retinal necrosis syndrome （ ARNs ） by vitrectomy at dif- ferent opportune moment. Methods A retrospective study was carded out in 5 hospitalized patients （ 7 eyes） with acute retinal necrosis syndrome during the period of september, 2009 to Octobe, 2011, The age ranged from 47 to 63 years old with average 55.2 ± 6.5. Two cases （2 eyes） with retinal detachment confirmed preoperative received vitrectomy com- bined with lens extraction and silicone oil tamponade. Ocular symptoms of 3 cases （ 3 eyes ） were aggravated during anfivi- rel therapy. Prophylactic vitrectomy were performed on 2 cases （ 2 eyes） without retinel detachment, while silieone oil tam- ponade were performed on another cases （ I eye ） which retinal detachment was found during vitrectomy. Two cases （ 2 eyes ） attacked sequentially were treated with antivira] therapy and laser photocoagulation. Results The follow-up period ranged from 6 to 24 months. Three eyes with silicone oil tamponade underwent silicone oil removal at a approximate interval of 6 months, whose visual acuity had no improvement, and recurrent retinal detachment developed in 1 eye. Retina attached in 2 eyes received prophylactic vitrectomy and 2 eyes attacked sequentially, which visual outcome was better than before treat- ment. Coltdllslolt Timely prophylactic vitrectomy was effective in preventing the development of retinal detachment and was associated with better recovery of visual function in eyes with ARNs,which antiviral therapy was invalid.

关 键 词：急性视网膜坏死综合征 玻璃体切割术 视网膜脱离 视网膜光凝 

分 类 号：R779.6[医药卫生—眼科]