康柏西普联合玻璃体切割术治疗视网膜血管瘤引起的 视网膜脱离的疗效观察

目的 回顾性分析视网膜毛细血管瘤(RCH)引起的视网膜脱离患者行单纯玻璃体切割手术或玻璃体腔注射康柏西普联合玻璃体切割手术的治疗效果。 方法 采用23 G玻璃体切割术和激光凝固和(或)冷冻疗法治疗15例(15眼)由RCH引起的视网膜脱离患者,其中6例(6眼)玻璃体腔内注射康柏西普7 d后行玻璃体切割术(注射组),9例(9眼)单纯行玻璃体切割术(未注射组)。记录手术时间、最佳矫正视力(BCVA)、眼底情况、荧光素血管造影(FFA)结果以及全身情况,并进行比较分析。 结果 未注射组中,7眼视网膜平复、肿瘤消退,1眼出现新的RCH,1眼复发视网膜脱离。注射组中,5眼术后视网膜平复、肿瘤消退,1眼复发视网膜脱离。 结论 23 G玻璃体切割联合玻璃体腔注射康柏西普,对RCH引起的严重的出血性视网膜脱离有较好的疗效,可明显减少手术时间及术中出血,减少手术次数。根据FFA的结果行激光光凝和(或)冷冻治疗是治疗成功的重要因素。

Outcomes of Intravitreal Conbercept and Vitrectomy for Retinal Detachment Caused by Retinal Capillary Hemangiomas

Objective To evaluate 5-year post-surgery therapeutic outcomes in retinal detachment cases caused by retinal capillary hemangiomas(RCHs)with or without intravitreal Conbercept. Methods23-gauge vitrectomy and laser photocoagulation/cryotherapy was performed for 15 patients(15 eyes)with severe hemorrhagic retinal detachment caused by RCH,including 6 cases(6 eyes)with intravitreal Conbercept 7 days before vitrectomy and 9 cases(9 eyes)without Conbercept. All patients were followed up for more than 5 years. Operation time, intraoperative bleeding, best corrected visual acuity(BCVA), photocoagulation and/or cryotherapy re-treatment times, ocular fundus, fluorescein angiogram(FFA), and systemic evaluation were observed and analyzed. Results Among the patients who had undergone vitrectomy surgery without Conbercept, the retina was flat and the tumor regressed in 7 eyes after first vitrectomy surgery. New RCH occurred in 1 eye while retinal re-detachment was found in 1 eye after silicon removal. For patients who had undergone vitrectomy surgery with intravitreal Conbercept, the retina was flat and the tumor regressed in 5 eyes after first vitrectomy surgery. New RCH occurred in 1 eye after silicon removal. Conclusion Pre-operative combination therapy with intravitreal Conbercept and followed by 23 G vitrectomy is an effective treatment for severe retinal detachment cases caused by RCH, which can shorten surgery time, and reduce intraoperative bleeding and postoperative re-treatment times. Moderate and repeated laser photocoagulation and/or cryotherapy according to FFA results are important for successful treatment.