玻璃体手术治疗特发性黄斑前膜并发医原性视网膜裂孔的临床分析

目的 探讨玻璃体手术治疗特发性黄斑前膜并发医原性视网膜裂孔的发生率、危险因素、临床特点和治疗预后.设计回顾性病例系列.研究对象行玻璃体手术治疗的特发性黄斑前膜患者84例88眼.方法 记录并分析玻璃体手术中或手术后发现医原性视网膜裂孔的病例.主要指标术中或术后出现裂扎的发生率、部位、数量、治疗方法和视网膜复位率.结果 88眼中共有8眼m现了14个医原性视网膜裂孔,总发生率为9.1%.周边裂孔的发生率(8.0%)高于后极部裂孔(1.1%). 13个周边裂孔均分布在有巩膜切口的象限(100%),并以术者主操作手一侧为主(62%).多数裂孔于手术中发现(88%).最终8眼视网膜全部复位(100%).结论 医原性视网膜裂孔是目前条件下玻璃体手术治疗特发性黄斑前膜的重要并发症之一,周边视网膜裂孔的发生率高于后极部裂孔.周边裂孔的发生主要与巩膜切口相关.(眼科,2008,17:258-261)     

视网膜内界膜剥离手术治疗高度近视黄斑裂孔视网膜脱离的疗效观察

目的 观察视网膜内界膜剥离治疗高度近视黄斑裂孔视网膜脱离的疗效. 方法 回顾分析25例25只眼高度近视黄斑裂孔伴视网膜脱离患者的临床资料.根据治疗方法 分为2组,A组为单纯玻璃体切割手术,13例13只眼;B组为玻璃体切割手术加吲哚青绿染色内界膜剥离,12例12只眼.所有患者行惰性气体填充,手术后保持面朝下体位7～15 d.观察最佳矫正分辨角对数(LogMAR)视力,检查眼底,光相干断层扫描(OCT)、B型超声检查视网膜复位及黄斑裂孔闭合情况,比较两组间疗效差异.手术后随访6～18个月,平均随访时间10个月. 结果 A组13只眼中,7只眼手术后视网膜复位,占53.8%;B组12只眼中,11只眼手术后视网膜复位,占91.7%.B组视网膜复位率明显优于A组(X2=4.427,P=0.046);25只眼中,手术后黄斑裂孔闭合者17只眼,占68.0%.其中,A组13只眼中,6只眼黄斑裂孔闭合,占A组患者的46.2%;B组12只眼中,11只眼黄斑裂孔闭合,占B组患者的91.7%.两组患者手术后黄斑裂孔闭合率比较,差异有统计学意义(X2=5.940,P=0.020).A组手术后最佳矫正LogMAR视力提高平均0.32,与手术前比较,差异有统计学意义(Z=-2.045,P=0.041),B组手术后最佳矫正LogMAR视力提高平均0.53,与手术前比较,差异有统计学意义(Z=-2.481,P=0.012).两组间手术后视力差异无统计学意义(U=51.5,P=0.16). 结论玻璃体切割联合视网膜内界膜剥离手术可能通过完全解除玻璃体黄斑牵引、增加视网膜顺应性而提高高度近视黄斑裂孔视网膜脱离的治疗效果.显著增加视网膜复位率及黄斑裂孔闭合率.     

视网膜内界膜剥离手术治疗高度近视黄斑裂孔视网膜脱离的疗效观察

目的 观察视网膜内界膜剥离治疗高度近视黄斑裂孔视网膜脱离的疗效. 方法 回顾分析25例25只眼高度近视黄斑裂孔伴视网膜脱离患者的临床资料.根据治疗方法 分为2组,A组为单纯玻璃体切割手术,13例13只眼;B组为玻璃体切割手术加吲哚青绿染色内界膜剥离,12例12只眼.所有患者行惰性气体填充,手术后保持面朝下体位7～15 d.观察最佳矫正分辨角对数(LogMAR)视力,检查眼底,光相干断层扫描(OCT)、B型超声检查视网膜复位及黄斑裂孔闭合情况,比较两组间疗效差异.手术后随访6～18个月,平均随访时间10个月. 结果 A组13只眼中,7只眼手术后视网膜复位,占53.8%;B组12只眼中,11只眼手术后视网膜复位,占91.7%.B组视网膜复位率明显优于A组(X2=4.427,P=0.046);25只眼中,手术后黄斑裂孔闭合者17只眼,占68.0%.其中,A组13只眼中,6只眼黄斑裂孔闭合,占A组患者的46.2%;B组12只眼中,11只眼黄斑裂孔闭合,占B组患者的91.7%.两组患者手术后黄斑裂孔闭合率比较,差异有统计学意义(X2=5.940,P=0.020).A组手术后最佳矫正LogMAR视力提高平均0.32,与手术前比较,差异有统计学意义(Z=-2.045,P=0.041),B组手术后最佳矫正LogMAR视力提高平均0.53,与手术前比较,差异有统计学意义(Z=-2.481,P=0.012).两组间手术后视力差异无统计学意义(U=51.5,P=0.16). 结论玻璃体切割联合视网膜内界膜剥离手术可能通过完全解除玻璃体黄斑牵引、增加视网膜顺应性而提高高度近视黄斑裂孔视网膜脱离的治疗效果.显著增加视网膜复位率及黄斑裂孔闭合率.     

视网膜周边激光光凝对下方裂孔硅油取出后视网膜再脱离的影响

目的 探讨首次玻璃体手术中下方周边部180°视网膜光凝对下方裂孔性视网膜脱离硅油取出手术后再脱离的影响.方法 对142例(142只眼)下方裂孔性视网膜脱离行玻璃体视网膜手术硅油填充,尔后行硅油取出的临床资料进行回顾性分析.激光光凝组81例为首次行玻璃体手术时即对其下半180°周边部视网膜(除裂孔外)实施堤坝样光凝;对照组61例未行预防性视网膜激光光凝.结果 硅油眼内填充时间为7～24周,平均硅油填充时间(11.8±2.6)周.硅油填充期间,光凝组硅油填充状态下视网膜脱离6例,占7.4%,对照组视网膜脱离10例,占16.4%,两组硅油状态视网膜脱离发生率比较,差异有统计学意义(P<0.05 ).油下视网膜脱离16例中,激光组6例.4例为增生性玻璃体视网膜病变引起,1例为预防性激光光凝手术后激光斑因受附近增生膜牵拉形成的新裂孔,1例原因不明:对照组10例,7例为遗漏小裂孔或原裂孔重新开放,3例为增生性玻璃体视网膜病变引起.硅油取出手术后11例患者发生视网膜再脱离,其中激光组3例,占3.7%;对照组8例,占11.4%.两组硅油取出后视网膜再脱离发生率比较,差异有统计学意义(P<0.05 ).硅油取出手术后视网膜再脱离11例中,激光组3例,2例为激光光凝斑受附近增生膜牵拉形成的新裂孔,l例为激光孔;对照组8例,4例为增生性玻璃体视网膜病变,2例为原裂孔开放,2例为原裂孔相邻部新裂孔.结论 下方裂孔性视网膜脱离在首次玻璃体手术中行预防性下半侧周边部180°视网膜激光光凝与裂孔愈合和硅汕取出手术后视网膜再脱离发生率下降有关联.     

巩膜环扎术在孔源性视网膜脱离玻璃体手术中的应用评价

目的 探讨巩膜环扎术在孔源性视网膜脱离(rhegmatogenous retinal detachement,RRD)玻璃体手术中的应用价值。 方法 回顾分析1995～1999年由我院RRD计算机分析系统收录的RRD行玻璃体手术者共254例中有随访记录的118例的临床资料。全部患者均为1次玻璃体手术，按手术中是否进行巩膜环扎分为巩膜环扎组和非环扎组，分别分析各组增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)级别、裂孔位置、不同眼内填充物与视网膜解剖复位率的关系。 结果 118例患者手术后随访1.5个月～3年，平均随访时间为6.5个月。视网膜复位96例，占81.4%,未复位22例，占18.6%。视网膜复位者中巩膜环扎组视网膜复位43例，占44.7%，非环扎组视网膜复位53例，占55.3%。巩膜环扎组与非环扎组PVR不同级别(C,D级)、不同填充物以及PVR C级不同部位视网膜裂孔(裂孔位于赤道前、赤道区或赤道前后均有裂孔)视网膜复位率比较其差异无显著性意义(P＞0.05)。而PVR D级视网膜裂孔位于赤道后者巩膜环扎组与非环扎组比较，非环扎组视网膜复位率高于环扎组，其差别有显著性意义(P＜0.05)。 结论 RRD玻璃体手术中巩膜环扎与否对视网膜脱离手术后视网膜复位率无明显影响。 (中华眼底病杂志, 2002, 18: 212-214)     

巩膜扣带手术联合玻璃体腔注气治疗周边裂孔合并黄斑裂孔性视网膜脱离

在周边裂孔引起的孔源性视网膜脱离中,约有1％～4％的患者继发有黄斑裂孔[1].对于原发性黄斑裂孔,玻璃体切割联合内界膜剥除惰性气体或硅油充填可使视网膜的解剖复位率及裂孔闭合率达到90％～100％[2,3].而对于继发于周边裂孔视网膜脱离的黄斑裂孔,报道的治疗方法和效果各不相同.主要方法一是应用玻璃体手术结合黄斑内界膜剥离等手段进行处理[1],二是应用巩膜扣带手术只处理周边裂孔,辅以玻璃体腔注射惰性气体或消毒空气以及激光光凝[4-7].惰性气体存在时间较长,可能会对玻璃体造成干扰而影响网膜复位,同时更长时间的体位要求也可能为患者带来不适.有报道在单纯周边裂孔性视网膜脱离的巩膜扣带手术治疗中,玻璃体腔注射消毒空气能够有效促进网膜复位,患者仅需俯卧位1 d[8].我们对一组周边裂孔继发黄斑裂孔性视网膜脱离患者通过巩膜扣带手术联合玻璃体腔注射消毒空气治疗,现将结果报道如下.     

玻璃体切除术联合巩膜扣带术治疗伴玻璃体牵引的孔源性视网膜脱离的临床效果

目的观察玻璃体切除术、空气填充联合节段性巩膜扣带术治疗伴玻璃体牵引的孔源性视网膜脱离的临床效果。方法回顾性病例系列研究。纳入2020年2月至2022年2月于郑州大学第一附属医院收治的伴玻璃体牵引的孔源性视网膜脱离患者101例(101只眼), 所有患者均接受玻璃体切除术、空气填充联合节段性巩膜扣带术治疗。术后随访6个月, 对单次手术视网膜复位情况、术后最佳矫正视力(BCVA, logMAR)及并发症进行分析。结果单次手术实现视网膜解剖复位94只眼, 占93.07%(94/101);首次手术后复发视网膜脱离7只眼, 占6.93%(7/101)。再次行玻璃体切除术伴硅油填充治疗后视网膜复位率为100.00%。不同术眼视网膜裂孔大小和裂孔数量的视网膜复位率比较, 差异有统计学意义(χ2=10.55, 7.15;P=0.005, 0.018)。手术前和术后6个月BCVA分别为1.27±0.93、0.43±0.35, 差异有统计学意义(t=9.82, P=0.001)。相关性分析结果显示, 手术后BCVA和术前BCVA呈正相关(r=0.40, P<0.001)。术前BCVA(P=0.024)...     

未找到明确裂孔的原发性视网膜脱离的术式选择

目的探讨孔源性视网膜脱离术前找不到裂孔如何选择手术方式。方法回顾分析2001年1月～2004年3月我院收治的屈光间质较透明,瞳孔能散大、PVRC3级以下的原发性视网膜脱离患者,选择巩膜扣带术及玻璃体视网膜手术的术前术后视力及视网膜复位情况。结果54例54眼中,33例行巩膜扣带术,第一次手术解剖复位率有84.8%(29/33眼),21例行玻璃体视网膜手术,第一次手术解剖复位率有90.5%(19/21只眼),两组第一次手术解剖复位率在统计学上无显著性差异(p=0.437)。在巩膜扣带术组和玻璃体视网膜手术组两组术前术后矫正视力无显著性差异(p=0.392)。术后随访(3～27)月,平均8.5月,巩膜扣带术组并发症明显少于玻璃体视网膜手术组。结论对未找到明确裂孔的孔源性视网膜脱离患者,尽可能用损伤最小、操作简单的巩膜扣带术来获得最大成功机会。     

不同程度高度近视黄斑裂孔性视网膜脱离玻璃体切割手术后疗效比较

目的 比较适度与极端高度近视黄斑裂孔性视网膜脱离(MHRD)曲安奈德(TA)染色辅助玻璃体切割及内界膜剥除联合长效气体眼内填充手术后的疗效.方法 41例高度近视MHRD住院患者41只眼纳入研究.其中,眼轴长度＜ 29 mm,视网膜色素上皮(RPE)及脉络膜萎缩轻,0～1级且深度≤2 mm的巩膜后葡萄肿者24只眼(适度组);眼轴长度≥29 mm,RPE及脉络膜明显萎缩,2～3级且深度＞2 mm的巩膜后葡萄肿者17只眼(极端组).两组患者均行TA染色辅助玻璃体切割手术联合内界膜剥除手术治疗,手术完毕时行C3F8眼内填充.对手术后发生视网膜再脱离者行再次手术.以手术后12个月为疗效判定时间点,比较两组患者视网膜复位率、黄斑裂孔闭合率及视力情况.结果 第1次手术后,适度组、极端组视网膜复位率分别为91.67％、64.71％,黄斑裂孔闭合率分别为58.33％、17.65％.两组第1次手术后视网膜复位率(P=0.049)、黄斑裂孔闭合率(x2=6.787,P=0.009)比较,差异均有统计学意义.第2次手术后,适度组、极端组视网膜复位率分别为95.83％％、88.24％,黄斑裂孔闭合率分别为58.33％、23.53％.两组比较,视网膜复位率间差异无统计学意义(P=0.560),黄斑裂孔闭合率间差异有统计学意义(x2=4.894,P=0.027).手术后12个月,适度组视力提高14只眼,视力不变9只眼,视力下降1只眼;极端组视力提高6只眼,视力不变8只眼,视力下降3只眼.两组视力情况比较,差异无统计学意义(x2 =0.209,P=0.647).结论 TA染色辅助玻璃体切割及内界膜剥除联合长效气体眼内填充手术后,适度高度近视MHRD患者视网膜复位率及黄斑孔闭合率较极端高度近视MHRD患者更高,但视力预后无明显差异.     

黄斑裂孔合并周边裂孔视网膜脱离的治疗分析

目的 探讨黄斑裂孔合并周边裂孔视网膜脱离的手术方法和疗效.方法 对12例(12只眼)黄斑裂孔合并周边裂孔性视网膜脱离进行玻璃体切除术联合巩膜扣带术、显微直视下冷凝术及全氟丙烷气体或硅油注入术.结果 随访6～36个月,视网膜复位良好,周边裂孔封闭,黄斑裂孔闭合,术后视力较术前有明显提高,盲目率有显著性下降(X2=10.971,P=0.001).结论 玻璃体切除联合巩膜扣带术、显微直视下冷凝术及全氟丙烷气体注入术治疗黄斑裂孔合并周边裂孔性视网膜脱离,疗效可靠,具有手术时间缩短及并发症少等优点.     

玻璃体切割术后视网膜脱离分析

目的 探讨玻璃体切割术后视网膜脱离的原因、特点、治疗方法。方法 回顾分析我科近年发生的１６例玻璃体切割术后视网膜脱离的特征及治疗过程。结果 发生率为６％,其中增生性糖尿病视网膜病变４例,非糖尿病性玻璃体混浊１２例,７５％于术后１周内出现视网膜脱离,６９％由医源性裂孔引起。二次手术治疗包括玻璃体切割、经巩膜视网膜冷冻、巩膜扣带、长效气体及硅油充填术。最终８１％视网膜复位、视力提高。结论 玻璃体切割术中应从各个环节防止视网膜的损伤,术后视网膜脱离经二次手术多数可以复位。     

Entry-site-related retinal detachment after pars plana vitrectomy

PURPOSE: Today, pars plana vitrectomy represents a standard surgical procedure for a number of retinal diseases that were previously considered inoperable. The aim of the present study is to investigate the entry site of pars plana vitrectomy as a possible source of retinal detachment. METHODS: We reviewed retrospectively all cases of uncomplicated pars plana vitectomies because of macular hole, macular pucker and diabetic macular oedema performed in our department between 1 January 2001 and 7 July 2004. RESULTS: Over 3.5 years, 244 pars plana vitrectomies because of macular disease were performed. Sclerotomy-related retinal detachment was observed in 11 (4.5%) cases. These retinal detachments occurred at a mean of 37 (2-100) days after surgery. They appeared within the first 4 weeks in 55% of the cases. CONCLUSION: Iatrogenic retinal breaks and detachment continue to be a severe complication of pars plana vitrectomy, despite improvements in instrumentation and surgical techniques. A 4.5% incidence of sclerotomy-related retinal detachment after simple vitrectomy calls for action. Current approaches to reduce this complication - such as circular peripheral cryoretinopexy, scleral buckling or 360 degrees laser treatment - are invasive. We recommend extended vitreous base cleaning with scleral indentation and examination of the entry sites, performed with a three-mirror lens or via careful indirect ophthalmoscopy into the periphery, 4 weeks after surgery.     

Iatrogenic retinal breaks complicating pars plana vitrectomy

To determine the current incidence and outcome of iatrogenic retinal breaks occurring during pars plana vitrectomy, the authors reviewed 404 consecutive operations done on eyes without preexisting retinal breaks. Thirteen eyes had 14 iatrogenic peripheral retinal breaks. Three other eyes had both peripheral breaks and posterior breaks. Twenty-five eyes had 43 posterior breaks. The incidence of peripheral breaks was 4% and of posterior breaks was 6%. Patients with proliferative diabetic retinopathy had a higher incidence of iatrogenic retinal breaks than those with other diagnoses. Peripheral breaks occurred most commonly just posterior to the site of insertion of the vitrectomy probe. Although six eyes required reoperation, 33 of 38 eyes had a successful anatomic outcome.     

Long-term anatomical and visual outcome of vitreous surgery for retinal detachment with choroidal coloboma

CONTEXT: Vitreous surgery has been advocated as an alternative treatment of selected retinal detachments with choroidal colobomas. AIM: To study the long term anatomical and visual outcome of choroidal coloboma with retinal detachment managed by pars plana vitrectomy with silicone oil tamponade. SETTING AND DESIGN: Retrospective study conducted in a tertiary eye care hospital. MATERIALS AND METHODS: Fourty two eyes of 40 patients with retinal detachments related to coloboma of the choroid without any peripheral breaks were analyzed. All eyes underwent pars plana vitrectomy with internal tamponade using silicone oil. Endolaser was performed along the coloboma border. Silicone oil was removed in 50% of patients. The main outcome measures were retinal reattachment and visual recovery. SPSS (Statistical Package for the Social Science), version 10.0 was used for analysis. RESULTS: The retina in all cases (100%) undergoing vitrectomy were completely reattached intra-operatively. After a mean follow-up of 14 months, 37 (88.1%) eyes had attached retina. The best corrected visual acuity was 10/200 or better in 33 (78.4%) eyes. The best corrected visual acuity improved from a preoperative median of counting fingers (range 20/40 to perception of light) to median best corrected visual acuity of 20/200 (range 20/40 to perception of light) at the end of 6 months. Of the 50% (21) cases that underwent silicone oil removal, two eyes had re-detachment of retina. CONCLUSION: Pars plana vitrectomy along with silicone oil tamponade for retinal detachment related to choroidal coloboma improves the long-term anatomical and visual outcome.     

Management of pseudophakic retinal detachment with undetectable retinal breaks

BACKGROUND AND OBJECTIVE: Difficulties encountered during the repair of pseudophakic retinal detachment are related to difficulties in peripheral retinal visualization and identification of retinal breaks. The implication of nonvisualized breaks in patients with pseudophakic retinal detachment is associated with lower rates of surgical success. This report decribes the results of a prospective trial to evaluate the efficacy of both scleral buckling surgery in the treatment of pseudophakic retinal detachment with undetected retinal breaks and pars plana vitrectomy techniques in the management of the cases that redetected after primary buckling surgery. PATIENTS AND METHODS: This study represents 25 cases of pseudophakic retinal detachment with undiagnosed retinal breaks. In each case, we performed a scleral buckling that extended over the circumference of the retinal detachment. Pars plana vitrectomy with internal subretinal fluid drainage and long-term tamponade were performed on 7 patients with uncomplicated recurrent retinal detachments after primary buckling surgery. The mean duration of follow up was 32 months. RESULTS: There were 25 eyes (24.5%) of pseudophakic retinal detachment with undiagnosed retinal breaks represented in our pseudophakic retinal detachment cases. Anatomic success was achieved after the initial scleral buckling surgery in 18 eyes (72%). The overall success rate was 92%. The visual acuity was 20/40 or better in 8 patients (32%), 20/80 to 20/40 in 6 patients (24%), 5/200 to 20/80 in 7 patients (28%), and light perception to hand movement in 4 patients (16%). Complications included vitreous hemorrhage, macular pucker, cystoid macular edema, and hypotony with proliferative vitreoretinopathy. CONCLUSION: Scleral buckling surgery in conjunction with cryotherapy is effective in the initial treatment of pseudophakic retinal detachment with undetectable retinal breaks. Pars plana vitrectomy with internal fluid-gas exchange and long-term tamponade can be used to treat these patients with recurrent retinal detachment after primary buckling surgery to get a higher overall success rate.     

Pars plana vitrectomy in the management of retained intravitreal lens fragments after cataract surgery

Purpose: To assess the outcome of patients who underwent pars plana vitrectomy for retained lens fragments after cataract surgery. Methods: A retrospective study of all consecutive cases with pars plana vitrectomy performed for retained lens fragment was conducted. Twenty‐seven eyes of 27 patients were included in the study. Results: Twenty‐four (89.9%) eyes received phacoemulsification. Pars plana vitrectomy was performed at the same sitting, or ranged from day 1?70 after cataract surgery. The mean follow up was 31.1 months. Final visual acuity of 6/12 or better was achieved in 15 (55.6%) patients. After excluding patients with pre‐existing eye diseases, 68.4% of patients had visual acuity 6/12 or better. Complications after pars plana vitrectomy included glaucoma (22.2%), retinal detachment (11.1%) and surgically induced necrotizing scleritis (3.7%). Conclusion: Ocular complications with poor visual outcome can occur after removal of intravitreal retained lens fragments complicating cataract surgery.     

Studies on vitrectomy cases associated with complicated branch retinal vein occlusion

PURPOSE: To examine the factors affecting visual outcome in vitrectomized cases associated with complicated branch retinal vein occlusion (BRVO). MATERIALS AND METHODS: Of 114 eyes of 113 patients with BRVO, ages, general complications, distribution of occluding vessels, location of retinal breaks, classification of vitreoretinal pathology and number of cases, period from onset of BRVO to vitreous hemorrhage and from vitreous hemorrhage to vitrectomy, number of operations, relationship between posterior vitreous detachment (PVD) and number of operations, post and preoperative pholocoagulation status, pre and postoperative visual acuity, and cases with poor visual outcome were analyzed. RESULTS: The visual prognosis was much better in the cases with vitreous hemorrhages only than those with proliferative membrane and retinal detachment (p = 0.0029). Repeated operations were needed in the cases of incomplete PVD (p = 0.0023). CONCLUSIONS: Early vitrectomy, especially in the cases of incomplete PVD, seems to be essential for management and treatment for better visual acuity.     

Vitrectomy for macular edema combined with retinal vein occlusion

This study was performed in order to evaluate the effect of vitrectomy in eyes with retinal vein occlusion associated with macular edema. Twenty-nine years eyes (27 patients) with branch retinal vein occlusion (BRVO), and 14 eyes (13 patients) with central retinal vein occlusion (CRVO) both associated with macular edema underwent phacoemulsification, intraocular lens implantation, pars plana vitrectomy and peeling of the posterior hyaloid membrane. Follow-up ranged from 12 to 32 months. Macular edema was reduced, and visual improvement was observed (p < 0.0001 in BRVO, p = 0.0257 in CRVO, paired t-test). Visual outcome was better in eyes with better visual acuity before surgery. Early vitrectomy may be recommended for retinal vein occlusion associated with macular edema. This revised version was published online in July 2006 with corrections to the Cover Date.     

Pars plana vitrectomy for vitreous amyloidosis

Thirty-six pars plana vitrectomies were performed on 30 eyes of 17 patients with biopsy-proven vitreous amyloidosis. Reopacification of the retrolental vitreous was the most common reason for vitrectomy revision, required in 24% of patients. Complications of amyloid or vitrectomy included retinal detachment requiring scleral buckling in 17% of eyes and glaucoma requiring filtering surgery in 17% of eyes. After a mean 35-month post-vitrectomy follow-up, 48% of eyes had visual acuities of 20/40 or better, and 32% of eyes had visual acuities between 20/50 and 20/100. Twenty percent of eyes had visual acuities of 20/200 or worse due either to persistent retinal detachment, open angle glaucoma, or residual opacification of the vitreous.     

玻璃体腔内注射贝伐单抗对增生性糖尿病视网膜病变玻璃体手术的影响

目的:评估术前1wk玻璃体腔内注射贝伐单抗对增生性糖尿病视网膜病变(PDR)玻璃体手术(PPV)的效果。方法:对46例PDR患者进行回顾性研究,46例患者随机分为玻璃体手术(PPV)组(n=28)和IVB组(n=18,PPV术前注射贝伐单抗)。玻璃体术前1wk注射贝伐单抗,比较两组间视力,医源性视网膜裂孔发生率,术中和术后出血情况。结果:术后1mo,PPV组和IVB组视力都明显提高(82.1%对88.9%)(P<0.01),两组间并无明显差异。医源性视网膜裂孔发生率PPV组18例,IVB组4例(64.3%对22.2%)(P<0.05)。术中出血PPV组28例,IVB组7例(100%对39%)(P<0.01),术后出血PPV组9例,IVB组0例(32.1%对0)(P<0.01)。结论:术前注射贝伐单抗可以减少增生性糖尿病视网膜病变玻璃体手术中医源性视网膜裂孔、术中出血和术后出血发生率。