巩膜切开联合眼内黏弹剂填充治疗术中及术后脉络膜上腔出血  

Sclerotomy combined with intraocular viscoelastic tamponade for the treatment of intraoperative or postoperative suprachoroidal hemorrhage

作　　者：蒋婷婷 王玲 江睿 Jiang Tingting;Wang Ling;Jiang Rui(Department of Ophthalmology,Eye&ENT Hospital of Fudan University,Shanghai 200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《中华眼外伤职业眼病杂志》2022年第5期383-386,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价巩膜切开联合眼内黏弹剂填充治疗术中及术后脉络膜上腔出血的临床效果。方法回顾性系列病例研究。分析复旦大学附属眼耳鼻喉科医院2011至2021年出现眼科手术中及术后脉络膜上腔出血的10例(10眼)的病例资料,所有患者均采用巩膜切开联合角膜缘入路眼内黏弹剂填充治疗。观察患者治疗前后视力、眼压及治疗效果。结果10例中,男性7例,女性3例,年龄38~85(59.4±18.9)岁。其中发生于晶状体超声乳化术中、白内障囊外摘出联合玻璃体切除术中、小梁切除术中、白内障囊外摘出术后、晶状体超声乳化联合小梁切除术后、角膜移植术后各1眼,以及晶状体超声乳化术后4眼。3例有高血压病史,2例有糖尿病病史。随访时间2~120个月。所有患者脉络膜出血范围为4个象限。从脉络膜上腔出血到手术,历时1~10(5.30±2.67)d。患者眼轴长23.37~27.81(25.57±1.32)mm。术后患者出现暂时性眼压升高,易被局部降眼压药物控制至正常。随访期末所有患者脉络膜上腔出血均消退。术前视力(BCVA,logMAR)为2.47±0.41,术后提高至0.81±0.72(t=6.65,P<0.001)。结论巩膜切开联合角膜缘入路眼内黏弹剂填充治疗术中及术后脉络膜上腔出血效果良好。Objective To evaluate the clinical efficacy of sclerotomy combined with intraocular viscoelastic tamponade for the treatment of intraoperative or postoperative suprachoroidal hemorrhage.Methods This was a retrospective case series study.The data of 10 eyes of 10 patients with intraoperative and postoperative suprachoroidal hemorrhage in the Eye and ENT Hospital of Fudan University from 2011 to 2021 were analyzed.All patients were treated with sclerotomy combined with intraocular viscoelastic tamponade through limbus.The visual acuity,intraocular pressure before and after treatment and therapeutic effects were evaluated.Results Among the 10 patients,there were 7 males and 3 females.The age ranged from 38-85 years with an average of(59.4±18.9)years.Suprachoroidal hemorrhage occurred during phacoemulsification in 1 eye,extracapsular cataract extraction combined with vitrectomy in 1 eye,trabeculectomy in 1 eye,extracapsular cataract extraction in 1 eye,phacoemulsification combined with trabeculectomy in 1 eye,corneal transplantation in 1 eye and after phacoemulsification in 4 eyes.Three patients had a history of hypertension and two had a history of diabetes.The follow-up time was from 2 to 120 months.The suprachoroidal hemorrhage range of all patients fell in 4 quadrants.The time from suprachoroidal hemorrhage to surgery was 1 to 10 days with an average of(5.30±2.67)days.The axial lengths of the patients were from 23.37 to 27.81 mm with an average of(25.57±1.32)mm.Transient elevation of intraocular pressure increase occurred in patients after the operation,which was easily controlled to normal with anti-glaucoma drug.Suprachoroidal hemorrhage subsided in all patients at the end of follow-up.Preoperative visual acuity(BCVA,logMAR)was 2.47±0.41,which increased to 0.81±0.72 postoperatively(t=6.65,P<0.001).Conclusion Sclerotomy combined with intraocular viscoelastic tamponade is an effective method for the treatment of intraoperative or postoperative suprachoroidal hemorrhage.

关 键 词：出血 脉络膜上腔 切开 巩膜 填充 黏弹剂 角膜缘入路 效果 治疗 

分 类 号：R779.6[医药卫生—眼科]