视网膜脱离手术后黄斑皱褶及其手术治疗  

Macular pucker after retinal detachment surgery and its surgery

作　　者：张少冲[1] 黄新华[1] 高汝龙[1] 张国明[1] 李春芳[1] 

机构地区：[1]中山医科大学中山眼科中心,510060

出　　处：《中国实用眼科杂志》2000年第10期606-607,共2页Chinese Journal of Practical Ophthalmology

摘　　要：目的 :探讨视网膜脱离 (简称网脱 )复位手术后黄斑皱褶的发生原因、手术治疗和预防措施。方法 :分析总结了 31例网脱复位术后发生黄斑皱褶的特点 ,并进行玻璃体手术治疗。应用视网膜钩、铲、眼内镊子、笛形针等器械将黄斑前膜剥离 ,使皱褶松开。结果 :黄斑皱褶产生的主要因素包括 :大的马蹄形裂孔、冷凝过度、术中眼内出血、术后裂孔后缘皱襞和不恰当的眼底激光治疗等。通过玻璃体手术 ,31例黄斑皱褶被完全松解并恢复正常黄斑形态 ,未见严重并发症产生。随访时视力均有明显提高。结论 :黄斑皱褶是现代网脱复位术常见并发症之一 ,再次玻璃体手术是有效的治疗方法。它可以通过网脱手术操作的改进而得以预防。Objective:To explore the causes leading to macular pucker after retinal detachment surgery and the operating methods and precautionary measures of it.Methods:31 cases with macular pucker after the retinal detachment surgery were analyzed about their clinical characteristics and undergone vitreoretinal surgery.Using the retinal pick,retinal spade,intraocular forcep and flute needle to separate the epiretinal membrane of the macular and release the puckers successfully.Results:The main causes leading to the macular puckers included large horseshoe retinal tear,excessive cyotherapy,intraocular hemorrhage,folding of the posterior edge of the retinal break after operation and inappropriate photocoagulation and so on.The macular puckers of 31 cases were completely released and the normal macular structure recovered.No serious complications occurred.The visual acuity improved distinctly during the follow up period.Conclusions:Macular pucker is one of the common complications of modern retinal surgery.Vitreoretinal surgery provide an effective measure.Improving the skills of retinal detachment surgery can prevent macular pucker.

关 键 词：视网膜脱离 黄斑皱褶 玻璃体视网膜手术 

分 类 号：R774.130.5[医药卫生—眼科]