睫状体肿瘤局部切除联合玻璃体视网膜手术的疗效分析  

Local resection of ciliary body tumors with vitreoretinal surgery

作　　者：魏文斌[1] 胡士敏[1] 朱晓青[1] 杨文利[1] 陈铮[1] 李彬[1] 孙宪丽[1] 王景昭[1] 

机构地区：[1]首都医科大学北京同仁眼科中心,100730

出　　处：《中华眼科杂志》2002年第5期286-288,I002,共4页Chinese Journal of Ophthalmology

摘　　要：目的　探讨睫状体肿瘤局部切除联合玻璃体视网膜手术的疗效、安全性及适应证。方法　 12例睫状体肿瘤患者 ,均经超声生物显微镜、B超等辅助诊断。其中男性 5例 ,女性 7例 ;年龄13～ 4 8岁 ,平均 32岁 ;肿瘤直径 5～ 2 0mm ,厚 4～ 12mm ;2例合并视网膜脱离。采用全身低血压麻醉或局麻法 ,行局部板层巩膜睫状体或局部板层巩膜睫状体前脉络膜切除联合玻璃体视网膜手术及异体巩膜移植术 ,包括晶状体和玻璃体切除、过氟化碳液体应用、眼内光凝、气体或硅油充填联合巩膜环扎术。切除的肿瘤送病理检查。结果　术后随访 7～ 38个月 ,平均 14 2个月 ,未发现肿瘤复发与转移。末次随访时 ,视力 <0 0 5者 1例 ,0 0 5～ 0 2者 3例 ,0 3～ 1 0者 8例。病理诊断 :睫状体恶性黑色素瘤 5例 ,黑色素细胞瘤 2例 ,无色素上皮瘤 3例 ,神经纤维瘤 1例 ,胶质瘤 1例。结论　睫状体肿瘤局部切除不仅能保存患眼、挽救视力 ,而且可对切除组织进行病理检查 ,以明确诊断 ;联合玻璃体视网膜手术可减少术后并发症 ,提高手术成功率 ;局部板层巩膜睫状体切除联合玻璃体视网膜手术是治疗睫状体良、恶性肿瘤的安全。Objective To investigate the effects, safety and indication of local resection of ciliary body tumors with vitreoretinal surgery Methods Twelve patients with ciliary body tumors, including 5 males and 7 females with the age range 13 48 years (average 32 years) were treated with local resection Ultrasound biomicroscopy (UBM) and ultrasonography confirmed the tumors, and the surgery was performed under hypotensive general anesthesia or local anesthesia The range of the diameters of tumors was 5 20 mm and of the thickness was 4 12 mm Retinal detachment was detected in 2 eyes Local lamellar sclerocyclectomy or sclerocyclochoroidectomy with vitreoretinal surgery was performed for the resection The surgery included lensectomy and vitrectomy using perfluorocarbon liquid, endolaser and gases or silicone oil tamponade and also scleral allograft if necessary The resected tumors were diagnosed by pathologic examinations Results There were no tumor recurrence and metastasis during follow up 7 38 months (average 14 2 months) In the last follow up date, the visual acuities were less than 0 05 in 1 case, 0 05 0 2 in 3 cases and 0 3 1 0 in 8 cases The pathologic diagnoses included malignant melanoma in 5 cases, melanocytoma in 2 cases, adenoma of non pigmented ciliary epithelium in 3 cases, neurofibroma in 1 case and glioma in 1 case Conclusion Local resection of ciliary tumor not only can conserve the eyeball, but also part of vision, and the accurate diagnosis can also be made from the resected tissues With vitreoretinal surgery, it can avoid complications and improve the success rate It is a safe and effective method for benign or malignant tumors of the ciliary body

关 键 词：睫状体肿瘤 眼科手术方法 局部极层巩膜睫状体切除术 玻璃体视网膜手术 诊断 手术方法 疗效 

分 类 号：R779.6[医药卫生—眼科]