23G玻璃体切割联合双重多次染色黄斑前膜、内界膜治疗黄斑裂孔性视网膜脱离  

23 gauge vitrectomy combined with double and multiple staining macular eptiretinal membrane and internal limiting membrane for macular hole retinal detachment

作　　者：刘鹏飞[1] 廖奇志[1] 刘淑伟[1] 白领娣 张怀强[1] 刘长颖[1] 

机构地区：[1]唐山市眼科医院,河北省唐山市063000

出　　处：《眼科新进展》2015年第9期878-881,共4页Recent Advances in Ophthalmology

摘　　要：目的 研究23 G玻璃体切割联合双重多次染色黄斑前膜、内界膜治疗黄斑裂孔性视网膜脱离的疗效。方法 回顾性分析我院确诊的伴黄斑前膜的黄斑裂孔性视网膜脱离患者19例19眼。接受三通道闭合式经睫状体平坦部23 G玻璃体手术。手术在曲安奈德标记、亮蓝染色辅助下23 G玻璃体切割,23 G内界膜镊分层剥离黄斑前膜及内界膜,硅油填充。3个月后取出硅油填充C3F8气体。观察手术时间及术后最佳矫正视力、黄斑裂孔闭合和视网膜脱离复位情况,同时观察术中、术后并发症情况。术后随访6-10（6.0±0.2）个月。结果 手术时间60-90 min,平均80 min;黄斑裂孔封闭、视网膜复位率为94.7%;术后最佳矫正视力0.01-0.04者3眼,0.05-0.10者12眼,0.12-0.25者4眼;术中剥离内界膜时部分视网膜点状出血,用笛针吸除大部分出血,必要时行视网膜激光光凝。术后2眼高眼压,予以局部降眼压药物治疗,7-13 d眼压平稳恢复正常。余未见其他术中、术后并发症发生。结论 23 G玻璃体切割联合双重多次染色黄斑前膜、内界膜治疗黄斑裂孔性视网膜脱离取得了较好疗效,不同程度上改善了视力,缩短了手术时间,减少了并发症的发生。Objective To investigate the effects of 23 gauge vitrectomy combined with double and multiple staining macular eptiretinal membrane and internal limiting membrane for macular hole retinal detachment.Methods Nineteen cases（19 eyes） with macular eptiretinal membrane and macular hole retinal detachment in our hospital were retrospectively analyzed,all cases underwent three ports vitrectomy using 23 gauge vitrectomy system,and the application of triamcinolone acetonide marking was made,and macular eptiretinal membrane and internal limiting membrane peeling was conducted with 23 gauge intraocular forceps with the help of of brilliant blue G staining successively.All patients were temponaded with silicone oil.Silicone oil was removed at postoperative 3 months,and all eyes were temponaded with C_3F_8.The operation time,postoperative best corrected visual acuity,healing of macular hole and retinal reposition were observed.The follow-up period was ranged from 6months to 10 months,meanly（6.0±0.2） months.Results The operation lasted for 60-90 minutes,meanly 80 minutes.The rate of macular hole closure and retinal reposition was 94.7%.The postoperative best corrected visual acuity was 0.01-0.04 in 3 eyes,0.05-0.10 in 12 eyes,0.12-0.25 in 4 eyes.When internal limiting membrane was peeling,part of all cases had dot retinal hemorrhage,the flute deedle was used to getter most of the hemorrhage,retinal laser photocoagulation was performed if necessary.High intraocular pressure appeared in 2 eyes,and backed to normal by local drug treatment within 7 days to 13 days after the surgery.Other intraoperative and postoperative complication was not found.Conclusion 23 gauge vitrectomy combined with double and multiple staining macular eptiretinal membrane and internal limiting membrane is very effective for macular hole retinal detachment,can improve visual acuity in different extents,shorten the operation time and reduce the complication.

关 键 词：双重多次染色 黄斑前膜 内界膜 黄斑裂孔性视网膜脱离 23G玻璃体切割系统 

分 类 号：R774.12[医药卫生—眼科]