过氟化碳液体用于球内异物取出术22例分析

目的 分析过氟化碳液体在球内异物取出术中的作用和效果。方法 采用扁平部玻璃体节除术，过氟化碳液体注入协助球内异物取出，并分析其术后效果。结果 ２２例２３眼手术全部异物取出，术后未发生视网膜脱离。７眼术前合并视网膜脱离者，术后视网脱离者，术后视网膜复位。术后视力〉０．０２者２１眼（９１．３％），〉０．１者１６眼（６９．６％），〉０．５者６眼（２６．１％），〉０．１者２眼（８．７％）。结论 玻璃体切除     

重水在玻璃体切除治疗复杂性玻璃体视网膜病变中的应用

为总结分析重水在玻璃体切除手术中联合气体／硅油填充治疗一组连续的复杂性玻璃体视网膜病人的手术效果，对一组连续的复杂性玻璃体视网膜病变病人行玻璃体切除，利用过氟化碳液体打开视网膜漏斗，内放液，稳定视网膜后进行剥膜及眼内激光等操作并联合气体／硅油填充，术后定期复查视力及视网膜复位情况。结果：手术解剖复位成功率为９０％。解剖复位眼中６７％（１８／２７）的眼视力较术前有不同程度的提高，其中视力达到０．０５以上者占５２％（１４／２７）。结论：玻璃体切除联合气体／硅油填充治疗复杂性玻璃体视网膜病变取得了良好的效果。特别是重水作为“流动的·液·体操作工具”应用于复杂的玻璃体切除手术中可改善手术操作，提高手术效果。     

视网膜切开与切除术在复杂性视网膜脱离手术中的应用

目的探讨视网膜切开与切除术在复杂性视网膜脱离手术中的临床应用。方法对１９９７年９月至１９９８年１２月间行视网膜切开与切除的２４例复杂性视网膜脱离患者作回顾性分析。其中巨大裂孔性网脱１５例,外伤牵引性视网膜脱离２例,增殖性血管性视网膜病变２例,复发性视网膜脱离３例,前部ＰＶＲ２例。手术联合玻璃体切除联合巩膜扣带技术,三通道睫状体平部晶体／玻璃体切除、膜剥离、过氟化碳液体使用、眼内激光、硅油－过氟化碳液体交换填充硅油或气体－过氟化碳液体交换填充Ｃ２Ｆ６气体。其中采用视网膜切开１０例,视网膜切除１０例,视网膜切开联合切除４例。结果２４例患者近期（出院时）观察视网膜解剖复位２２例,有效率为９１．７％,１９例视力不同程度的改善。１５例巨大裂孔僵硬边缘切除或裂孔两边松驰性视网膜切开,解剖复位１４例,视力改善。术后随访１９例,时间为３～１４月（平均６月）,视网膜复位１８例,占９４．７％,视力≥０．０５者９例,占５０％,眼球萎缩及低眼压１例。结论视网膜切开与切除术提高了复杂性视网膜脱离手术的成功率。     

硅油在复杂性视网膜脱离子手术中的应用

探讨硅油在治疗复杂性视网膜脱离手术中的应用以及硅油的并发症。方法采用玻璃体切除联合硅油填充对复杂性视网膜脱离４３只眼进行治疗。结果术后平均随访６个月,视网膜解剖复位者３２只眼,复位率为７６％,术后２３只眼视力≥０．０２。     

增殖性玻璃体视网膜病变D3级伴严重前部玻璃体增殖的治疗

目的：探讨视网脱离中病变严重、常规治疗很困难的增殖性玻璃体视网膜病变(proliferative vitreoretinopathy，PVR)D3级伴严重前部玻璃体增殖患者的治疗方法。 方法：回顾分析t994年7月~1995年12月我中心用巩膜冷凝、环扎、硅胶外加压，玻璃体切除，视网膜前膜分离、切除，视网膜松解性切开、切除，过氟化碳液体注入，眼内外排液及硅油眼内填充等方法综合治疗PVR-D3级伴严重前部PVR患者14例14只眼的临床及随访结果。 结果：14只眼中，10只眼视网膜完全复位，3只眼次全复位，1只眼失败。术后视力除未成功者外，其余均有所提高，视力达0.02或以上者9只眼。 结论：运用各种玻璃体视网膜显微手术技术，辅以过氟化碳液体及硅油眼内填充等全面积极地治疗，可使部分严重、复杂的视网膜脱离患者得以治愈，恢复有用视力。 （中华眼底病杂志，1997，13：179-180）     

过氟化碳液在复杂视网膜脱离手术中的应用

目的：探讨过氟化碳液在复杂视网膜脱离手术中的作用。 方法对１３例伴巨大裂孔或严重增殖性玻璃作视网膜病变的复杂视网膜脱离行玻璃体切除及视网膜复位术，术中应用过氟化碳液。 结果术后随访２～１０ｍｏ，１２眼视网膜复位，１０眼视力较术前提高，其中 ６眼＞０． １；术后视网膜下过氟化碳小液滴残留１例。 结论过氟化碳液的应用，有利于提高复杂视网膜脱离的解剖复位率，并改善视功能。     

葡萄膜视网膜炎伴复杂性视网膜脱离的处理

目的 观察葡萄膜视网膜炎所致视网膜脱离的临床特征及玻璃体切除手术效果。方法 回顾性分析11例（11只眼）因葡萄膜视网膜炎所致复杂性视网膜脱离，6只眼为巨大裂孔，2只眼为周边多发网状孔，3只眼无明确裂孔，PVR程度C3－D1级。患者均玻璃体切除术手术，术后充填硅油8只眼，充填长效气体3只眼。结果 一次手术8只眼视网膜获良好复位，2只眼二次手术成功，1只眼拒绝再手术。8只眼视力有增进（72．7％），视力在0.02以上有6只眼（54．5％）。结论 葡萄膜视网膜炎可致复杂性视网膜脱离，玻璃体切除视网膜复位效果肯定，并存在的视网膜脉络膜、视神经、血管病变及黄斑疤痕是限制视功能恢复的主要原因。     

视网膜脱离伴前部增生性玻璃体视网膜病变的手术

目的：探讨视网膜脱离中病变严重，伴前部增生性玻璃体视网膜病变（anterior proliferative vitreoretionopalthy,APVR)的手术治疗方法。方法：对57例（57眼）复杂性视网膜脱离伴APVR患者行巩膜环扎，硅胶外加压、玻璃体切除，视网膜前膜分离、切除、视网膜松解性切开、切除、过氟化碳液体注入，眼内排液及硅油眼内填充等,崆春治疗效果。结果：痊愈45例，成功率79％，8眼好转，占14％，4眼无效，占75，术后视力除手术失败者外，均有所提高。结论：运用各种玻璃体视网膜显微手术技术，对APVR的认识和处理能力提高，可以使部分严重，复杂的视网膜脱离复位手术成功率提高。     

儿童孔源性视网膜脱离手术治疗特点及疗效分析

目的：探讨儿童孔源性视网膜脱离手术治疗特点及疗效。方法：对采用不同手术方法治疗的儿童孔源性视网膜脱离患者108例（116只眼）进行效果分析。结果：21只眼行巩膜外加压术,1次手术视网膜复位19只眼,术后视力≥0．02者14只眼。97只眼行玻璃体切除术,1次手术视网膜复位58只眼（59．8％）,最终视网膜复位83只眼（85．6％）,术手视力≥0．02者64只眼（66．0％）。术中使用膨胀气体填充11只眼,1次性视网膜复位7只眼,术后视力≥0．02者5只眼。使用硅油填充89只眼,1次性视网膜复位51只眼（57．3％）,最终视网膜复位7积眼（85．4％）,术后视力≥0．02者59只眼（66．3％）。结论儿童孔源性视网膜脱离的治疗首选巩膜加压术,玻璃体切除者,硅油作为眼内填充物较膨胀气体具有更大的优越性。视网膜切开术是严重增殖性玻璃体视网膜病变者视网膜复位的有效方法,但应慎重选择手术对象。     

玻璃体手术结合光凝治疗伴视网膜脱离的晚期Coats'病

目的：评估玻璃体手术结合眼内电凝光凝治疗伴渗出性视网膜脱离的晚期Ｃｏａｔｓ’病的疗效。方法：采用玻璃体切割,视网膜切开内引流、电凝、光凝及过氟化碳液体应用,治疗伴渗出性视网膜脱离Ｃｏａｔｓ’病１６例（１６只眼）,随访６～２４个月（平均１６月）。结果：术后视网膜复位率（１５／１６）９３．２％。１６只眼均保持术前视力,眼压控制于正常范围。结论：本方地多数晚期Ｃｏａｔｓ’病有效,可以使视网膜复位,维持现     

Study on Application of the Silicone Oil in the Reattachment of Complicated Retinal Detachment

Sixty eyes with complicated retinal detachment were treatedby vitrectomy combined with silicone oil tamponade (27 eyes of PMR gradeD,15 eyes of giant retinal tears with posterior flat folded-over,13 eyes ofposterior or macular hole,5 eyes of traumatic PVR).After 3-24 monthsfollow-up,the study showed retinal anatomic reattachment in 48 eyes inwhich the visual acuity of 32 eyes was 0.05 or better.The authorsconsider that vitrectomy and peeling make the silicone oil tamponadeperfect the vitreous surgery and improve the successful rate.The theoryof silicone oil tamponade,the indications,advantages and disadvantagesof silicone oil tamponade are discussed in this paper.Eye Science1993,9:146-148.     

Perfluoro-octane in the treatment of giant retinal tears with proliferative vitreoretinopathy.

Giant retinal tears complicated by proliferative vitreoretinopathy (PVR) pose one of the more complex problems in vitreoretinal surgery. The authors developed a technique using perfluoro-octane, a temporary vitreous substitute that is heavier than water, combined with vitrectomy, scleral buckling, fluid-gas exchange, and direct manipulation of the retina to treat these cases. Ten eyes with giant retinal tears and grade D-1 PVR or worse were treated. In all eyes, the retina was successfully reattached at the end of surgery. Nine of the ten retinas remained attached after 6 months of follow-up. Five eyes required a total of six reoperations for epiretinal membrane formation without retinal detachment. The one eye in which the retina did not remain reattached developed severe recurrent PVR and iris neovascularization. Visual acuity improved in 8 of 10 eyes. Final visual acuity was 20/400 or better in 8 of 10 eyes, and 20/80 or better in 4 eyes.     

The management of giant retinal tears with silicone oil

PURPOSE: To report the surgical success of vitrectomy with silicone oil tamponade in the treatment of retinal detachment associated with giant retinal tears due to various factors. METHODS: We retrospectively evaluated 21 eyes of 21 patients with retinal tears 90 degrees or greater that underwent vitrectomy, with injection of perfluorocarbon liquids and silicone oil tamponade. Eight eyes (38.1%) had previous ocular surgery (4 aphakia-pseudophakia, 4 pars plana vitrectomy), 4 eyes (19.0%) had a history of trauma (blunt injuries in 2 and penetrating injury in 2), 3 (14.3%) had high myopia. Six eyes (28.6%) had no known condition predisposing to development of giant retinal tear. RESULTS: Retinal attachment was obtained in 17 (80.5%) of 21 eyes, with a mean follow-up of 12.5 months. Visual acuity improved in 15 eyes (71.4%). CONCLUSIONS: Pars plana vitrectomy with silicone oil tamponade proved highly effective in giant retinal tears in terms of anatomical and functional results.     

全玻璃体切除术治疗巨大裂孔视网膜脱离的临床效果观察

目的观察全玻璃体切除手术治疗巨大裂孔视网膜脱离的效果。设计回顾性病例系列。研究对象2003年7月至2008年1月连续在中山眼科中心就诊的原发性巨大裂孔视网膜脱离患者17例（17眼）。方法对所有17例（17眼）患者行全玻璃体切除手术治疗,术中做充分的全玻璃体切除,剥离粘连玻璃体皮质,重水压平视网膜后,切除视网膜裂孔后缘翻卷的边,眼内光凝,气饭交换和硅油填充。术中3例切除裂孔前瓣,9例切除合并裂孔前瓣的睫状体非色素上皮脱离。联合环扎1例,行晶状体咬切1例。术后平均随访24．5±8．5个月,观察视力、视网膜平伏情况及并发症,并作相应处理。主要指标视力、视网膜平伏情况及并发症。结果其中1例术后出现新裂孔,另1例术后7个月玻璃体增生牵拉导致视网膜脱离,其余15例患者在术后2～18个月顺利取出硅油,视网膜保持复位。失访1例。最后一次随访最好矫正视力：光感-指数2例,0．02±0．35例,0．5±0．76例,≥1．03例,与术前相比明显好转（χ2=17．01,P〈0．05）。结论平均随访2年的结果显示,全玻璃体切除术、部分视网膜切除、眼内光凝和硅油填充治疗巨大裂孔性视网膜脱离具有较好的手术效果。     

非常复杂型视网膜脱离的治疗探讨

目的:探讨治疗非常复杂型视网膜脱离的方法。方法:31例(31眼)非常复杂型视网膜脱离,包括原发性裂孔性视网膜脱离伴PVR-D3级及前段玻璃体严重增殖者14只眼;巨大裂孔性视网膜脱离伴严重PVR 8只眼;严重眼外伤伴眼内容物脱出及严重PVR 9只眼。采用巩膜冷凝、环扎、硅胶填压、玻璃体切割、视网膜前膜剥离/切除,视网膜松解性切开,过氟化碳液体注入,眼内/眼外排液以及硅油眼内填充等方法治疗。结果:随访3～16个月,31眼中,21只眼视网膜完全复位,占67.7％;5只眼大部分复位,占16.1％;5只眼未能复位,占16.1％。术后视力,除了失败的5只眼外,在其余的26只眼中,有一眼视力较术前下降,其余25只眼的视力均有不同程度的提高。结论:PVR及巨大裂孔性视网膜脱离的效果较好,分别有71.4％及87.5％完全复位,严重外伤的治疗效果较差。眼科学报1998;14:90—93。     

Vitrectomy in Terson syndrome. Report of 18 cases]

A vitrectomy was performed in 18 eyes (15 patients) with vitreous hemorrhages due to Terson's syndrome. The average age of the patients was 46.5 +/- 14.4 years. The mean interval between the acute event of an intracranial hemorrhage and the vitrectomy was 6.8 +/- 4.9 months. The vitreous hemorrhage was associated with epiretinal membranes in 3, PVR in 2, and retinal breaks and/or rhegmatogenous retinal detachment in 3 eyes. The vitrectomy had to be combined with membrane peeling in 2, encircling procedures or exoplants in 4, cryotherapy in 5, endolaser in 1, and air/SF6 gas filling in 3 eyes. A missing or incomplete posterior vitreous detachment in 8 eyes was associated with a higher risk of PVR and retinal detachment. Two eyes with this condition needed 3 secondary operations. The mean follow-up duration was 32 (1 to 126) months. Two patients died 4 and 11 months after the operation. The visual acuity improved significantly following vitrectomy in all 18 eyes. The final visual acuity was better than 20/40 in 73% and 20/25 to 20/20 in 56%. The initial postoperative visual acuity decreased later on due to nuclear cataract in 7 of 10 eyes of patients over 45 years of age. A complicated cataract developed in only 1 of 8 eyes of younger patients who maintained a mean visual acuity of 20/25. Vitrectomy for Terson's syndrome is recommended in bilateral cases without spontaneous clearing of the vitreous within 3 months, as well as in cases with PVR and imminent retinal detachment.(ABSTRACT TRUNCATED AT 250 WORDS)     

Prognostic factors associated with outcomes after giant retinal tear management using perfluorocarbon liquids

PURPOSE: To identify prognostic factors for visual acuity and anatomic outcomes associated with giant retinal tear management using intraoperative perfluorocarbon liquids. METHODS: All patients with giant retinal tears without proliferative vitreoretinopathy (PVR) who underwent management with intraoperative perfluorocarbon liquids between 1994 and 2005 were reviewed. RESULTS: The study included 115 patients (117 eyes), 93 (80.9%) males and 22 (19.1%) females, with a mean age of 30.3+/-15.2 years. Mean follow-up period was 29.7+/-26.7 months. Success rate with primary procedure was 78.6%, which increased to 94% with multiple surgeries. On univariate analysis, factors significantly associated with final visual acuity better than 20/200 included phakic/clear lens at presentation (p=0.0113), partial retinal detachment (p=0.0233), absence of all postoperative complications (p=0.0122), absence of recurrent retinal detachment (p=0.0406), and absence of postoperative PVR (p=0.0062). Logistic regression analysis highlighted that phakic/clear lens at presentation, unfolded flap of the giant tear, absence of postoperative cataract, and absence of postoperative PVR were associated with final visual acuity better than 20/200. On univariate analysis, use of gas tamponade was significantly associated with recurrent retinal detachment (p=0.0190). Logistic regression analysis highlighted that placement of an encircling scleral buckle and use of silicone oil tamponade were associated with anatomic reattachment with primary procedure. CONCLUSIONS: Encircling scleral buckling and silicone oil tamponade decrease the risk of recurrent retinal detachment.     

全氟化碳液体在孔源性视网膜脱离手术中的应用

目的　探讨全氟化碳液体在孔源性视网膜脱离玻璃体切割手术中的应用。方法　对 2 0 0 0年 6月～ 2 0 0 3年6月因孔源性视网膜脱离行玻璃体手术并在手术中使用全氟化碳液体的 94例 95眼进行回顾总结。结果　术后视网膜复位 85眼 ( 89 4% )。术后视力提高 76眼 ( 80 % ) ,视力无改变 12眼 ( 12 6% ) ,视力下降 7眼 ( 7 4% )。术后前房全氟化碳液体残留 3眼 ,玻璃体腔内全氟化碳液体残留 2眼 ,患者随访过程中未发现对角膜、视网膜及眼压产生影响。结论　全氟化碳液体作为孔源性视网膜脱离手术中的暂时性眼内填充物是安全有效的。     

玻璃体切除术治疗人工晶状体眼视网膜脱离

目的 探讨玻璃体切除术治疗人工晶状体眼视网膜脱离（ｔｒｔｉｎａｌ ｄｅｔａｃｈｍｅｎｔ,ＲＤ）的效果。方法 对３２例（３２只眼）植入人工晶状体后ＲＤ患眼行玻璃体除术,其中首次治疗采用玻璃体切除术１１只眼（３４．４％）,巩膜扣带术失败后再行玻璃体切除术２１只眼（６５．６％）,玻璃体切除术中联合硅油充填１０只眼（３１．３％）,玻璃体切除术同时行人工晶状体取出１２只眼（３７．５％）。术后随诊６个月至５年