玻璃体切割术治疗眼内恶性肿瘤的热点与争议  

Controversy of vitrectomy in the treatment of intraocular malignancy

作　　者：高静歌 Danian Chen Gao Jingge;Danian Chen(Research Laboratory of Ophthalmology and Vision Sciences,State Key Laboratory of Biotherapy,West China Hospital,Sichuan University,Chengdu 610041,China;Wangjiang Hospital of Sichuan University,Chengdu 610065,China;Lunenfeld-Tanenbaum Research Institute,Mount Sinai Health System,Departments of Ophthalmology and Vision Science,Laboratory Medicine and Pathology,University of Toronto,Toronto M5G IX5,Canada)

机构地区：[1]四川大学华西医院眼科研究室,成都610041 [2]四川大学望江医院,成都610065 [3]多伦多大学眼科及西奈山医院研究所,多伦多M5G IX5,Canada

出　　处：《中华实验眼科杂志》2021年第3期249-253,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目(81870665)。

摘　　要：视网膜母细胞瘤(RB)是婴幼儿最常见的原发性眼内恶性肿瘤,而脉络膜黑色素瘤是成人眼部最常见的原发性恶性肿瘤。随着眼内肿瘤诊断和治疗方法和技术的不断进步,患者的生存率显著提高,生存时间明显延长,眼内恶性肿瘤治疗目的也从单纯的挽救患者生命逐渐转变为在挽救生命的基础上尽量保全眼球。尽管目前眼内恶性肿瘤的治疗方案多样,但是对于部分难治性肿瘤,达到保全眼球的目标仍然具有很大挑战。近年来随着手术设备和操作技术的改进,玻璃体切割术再次成为难治性眼内期RB及脉络膜黑色素瘤的治疗方法之一,为这些眼内恶性肿瘤患者保全眼球带来了希望。然而,这种疗法仍有一定的并发症,因此存在争议,在治疗过程中一定要谨慎选择病例,小心实施手术,积极结合其他化学疗法和/或放射治疗及局部治疗方案,并且严密随访。Retinoblastoma(RB)and choroidal malignant melanoma are the most common primary intraocular malignancy in children and adults,respectively.Due to the advance in the diagnosis and treatment of intraocular tumors,the survival rate and survival time of the patients are significantly improved.The goal of the therapy for the patients of intraocular malignant tumors has gradually changed from simply saving life to trying to preserve eyeball on the basis of saving life.Although there are various treatment options for intraocular malignant tumors,eye salvage is still an great challenge for the patients with refractory tumors.In recent years,vitrectomy has been used again by some doctors to the treatment of refractory RB and choroidal malignant melanoma,which undoubtedly gives the hope of eye salvage to the patients with intraocular malignant tumors.However,this therapy arouse controversy because serious intraoperative or postoperative complications occurred in some patients.Ophthalmologists should select suitable indications for this surgery cautiously,perform the operation carefully,combine other chemotherapy and/or radiotherapy and local treatment and close follow-up if necessary.

关 键 词：视网膜母细胞瘤 脉络膜黑色素瘤 玻璃体切割术 肿瘤复发 肿瘤转移 争议 

分 类 号：R739.7[医药卫生—肿瘤]