急性视网膜坏死综合征全玻璃体切除的治疗效果

目的 探讨急性视网膜坏死综合征(ARNS)全玻璃体切除手术的治疗效果.方法 对2003年3月至2006年10月,共连续17例(17只眼)ARNS患者在我科做了玻璃体手术.伴有视网膜脱离13例,无视网膜脱离4例.所有患者均采用全玻璃体切除术,剥离视网膜前膜和坏死视网膜,部分病人做了松解性视网膜切开或切除,用重水压平视网膜后眼内光凝或直接眼内光凝,气液交换后,用C3F8填充2例和用硅油填充15例.取出以前环扎带1例和做环扎1例.结果 追踪时间至少半年,除膨胀气体填充的2例手术失败外,其余15例患者在术后1～12月顺利取出硅油,视网膜保持复位.最后一次随访最好矫正视力:光感至指数4例,0.2～0.3者5例,0.5～0.7者5例,≥1者3例.结论 全玻璃体切除术、眼内光凝和硅油填充治疗ARNS具有良好地手术效果.

The effect of total vitrectomy for acute retinal necrosis syndrome

Objective To determine the effect of total vitrectomy treating acute retinal necrosis syn-drome (ARNS).Methods A consecutive 17 eyes of 17 human immunodeficiency virus-negative patients with ARNS were surgeried with total vitrectomy technique between March 2003 and October 2006.There were reti-nal detachment (RD)in 13 eyes and no RD in 4 eyes.The surgical techniques included total vitrectomy, mere-bran-peeling of epiretinal membranes and necrosing retina relaxing retinotomies/retinectomies,injecting per-flurocarbon liquid, endolaser photocoagulation, air/fluid exchange, tampornade of perfluropropane gas or sili-cone oil.The perfluropropane gas was injected in 2 eyes and silicone oil in 15 eyes.A previuos encircling band was removed in one case and an encircling was placed in only one case.Results The following-up times were 6 monthes at least.Except the retinal detachment was occurred in two patients with the tampornade of perfluro-propan gas,the remaining patients maintained retinal attachment after the initial operation.The silicone oil was uneventfully removed in 15 patients from one to 12 monthes.The final best-correcting visual acuity was light perception to counting fingers in 4 eyes,0.2～0.3 in 5 eyes,0.5～0.7 in 5 eyes,≥ 1 in 3 eyes.Conclusion There is a favorable effect in ARNS with the treatment of total vitrectomy, endolaser photocoagulation and tampor-nade of silicone oil.