曲安奈德玻璃体内注射联合23G微创玻璃体切割术治疗脉络膜脱离型视网膜脱离的疗效分析  

23-gauge micro-invasive vitrectomy combined with triamicinolone acetonide intravitreal injection for retinal detachment associated with choroidal detachment

作　　者：吴敏[1] 薛黎萍[1] 肖丽波[1] 胡竹林[1] 李云琴[1] 

机构地区：[1]昆明医科大学第四附属医院眼科,云南省第二人民医院眼科,云南省昆明市650021

出　　处：《眼科新进展》2014年第12期1144-1146,共3页Recent Advances in Ophthalmology

基　　金：云南省教育厅科学研究基金项目(编号:2011C079);云南省卫生科技计划项目(编号:2012WS0109);云南省高层次卫生技术人才培养专项经费资助~~

摘　　要：目的探讨曲安奈德玻璃体内注射联合23G微创玻璃体切割术治疗脉络膜脱离型视网膜脱离的疗效。方法 2012年1月至2013年1月在我院就诊的28例脉络膜脱离型视网膜脱离患者,经过术前短期糖皮质激素治疗后,行23G微创玻璃体切割术治疗,术中联合玻璃体内注射曲安奈德4 mg,术后随访6~12个月,观察术后视力恢复、视网膜复位和并发症发生情况。结果一次手术视网膜解剖复位率为89.3%,再次术后视网膜解剖复位率100.0%。术前Log MAR视力为1.98±0.50,术后Log MAR视力为1.17±0.40,差异有统计学意义（t=8.371,P〈0.05）。末次随访眼压（16.2±3.7）mm Hg（1k Pa=7.5 mm Hg）,与术前眼压（6.4±2.3）mm Hg相比,差异有统计学意义（t=17.613,P〈0.05）。术后有15例出现一过性高眼压,3例白内障加重,1例发生后发性白内障,5例术后少量结膜下出血。结论 23G微创玻璃体切割术联合术中曲安奈德玻璃体内注射治疗脉络膜脱离型视网膜脱离是安全有效的。Objective To discuss the effects of 23-Gauge micro-invasive vitrectomy combined with triamicinolone acetonide intravitreal injection for retinal detachment associated with choroidal detachment. Methods Twenty-eighth cases of retinal detachment associated with choroidal detachment in our hospital from January 2012 to January 2013 were treated by 23-Gauge micro-invasive vitrectomy combined with preop- erative systemic steroid and intravitreal injection of 4 mg triamcinolone acetonide during operation. All the cases were followed-up for 6 to 12 months. The anatomic retinal reat- tachment,visual acuity and postoperative complications were observed. Results The retinal reattachment rate after the primary surgery and the second surgery was 89.3% and 100. 0% , respectively. The preoperative and postoperative LogMAR visual acuity were 1.98 ± 0.50 and 1.17 ± 0.40, respectively, the difference was significant statistically （ t = 8. 371 ,P 〈 0.05 ）. The intraocuiar pressure at last visit was （ 16.2 ±3.7 ） mmHg （ 1 kPa = 7.5 mmHg）, which was statistically significant higher than pre-operation （6.4 ±2.3 ） mmHg, the difference was significant statistically（ t = 17.613 ,P 〈 0.05 ）. Post-operative complications included 15 cases of transient high intraocular pressure, 3 cases of cataract, 1 case of posterior capsular opacification and 5 cases of mild subconjunctival hemmorhage. Conclusion 23-gauge micro-invasive vitrectomy combined with intrav- itreal injection of triamcinolone acetonide during operation is effective and safe for retinal detachment associated with choroidal detachment.

关 键 词：脉络膜脱离 视网膜脱离 23G微创玻璃体切割术 曲安奈德 玻璃体内注射 

分 类 号：R774.12[医药卫生—眼科]