曲安奈德辅助显示玻璃体切割术中残留的玻璃体后皮质

目的探讨在曲安奈德(triamcinoloneacetonide,TA)辅助的PPV手术中行人工玻璃体后脱离后,玻璃体皮质的残留情况。方法90例患者行TA辅助的经睫状体平坦部玻璃体切割术,其中增殖性糖尿病视网膜病变34例(34只眼)、糖尿病性黄斑水肿16例(16只眼)、特发性黄斑裂孔17例(17只眼)、孔源性视网膜脱离23例(23只眼)。在常规的人工玻璃体后脱离后,在TA辅助下残留的玻璃体皮质被分为三种类型:弥散型、局限型和无残留。结果79.4%的增殖性糖尿病视网膜病变患者残留玻璃体皮质为弥散型,11.8%为局限型,8.8%为无残留;56.3%糖尿病性黄斑水肿患者为弥散型,25.0%为局限型,18.7%为无残留;特发性黄斑裂孔患者29.4%为弥散型,17.6%为局限型,53.0%为无残留;39.1%孔源性视网膜脱离患者为弥散型,17.4%为局限型,43.5%为无残留。结论常规的人工玻璃体后脱离后玻璃体皮质残留仍然存在,糖尿病患眼容易表现为弥散型。

Triamcinolone acetonide-assisted vitrectomy to visualize the residual vitreous cortex after surgical posterior vitreous separation

Objective To visualize the residual vitreous cortex after surgical posterior vitreousseparation during triamcinolone acetonide (TA)-assisted pars plana vitrectomy. Methods A TA-assistedvitrectomy was performed on 90 patients with the following diseases: proliferative diabetic retinopathy (PDR)34 cases (34 eyes), diabetic macular edema (DME) 16 cases(16 eyes), idiopathic macular hole (IMH) 17cases (17 eyes), rhegmatogenous retinal detachment (RRD) 23 cases(23 eyes). After the routine surgicalposterior vitreous separation, the residual vitreous cortex was divided into 3 types: diffuse type, focal type,and no residual vitreous cortex. Results 79.4% of the PDR eyes demonstrated the diffuse type, 11.8% werethe focal type, and 8.8% were no residual vitreous cortex; in DME eyes they were 56.3%, 25.0%, 18.7%respectively; in IMH eyes they were 29.4%, 17.6%, 53.0%; in RRD eyes they were 39.1%,17.4%, 43.5%.Conclusion After routine surgical posterior vitreous separation the residual vitreous cortex was exist. Thediabetic eyes are prone to be the diffuse type.