保留晶状体的玻璃体视网膜手术治疗巨大视网膜裂孔

目的探讨保留透明晶状体的玻璃体视网膜手术治疗伴有增生性玻璃体视网膜病变(proliferativevitreoretinopathy,PVR)的巨大视网膜裂孔(giant retinal tears，GRT)的手术方法及效果。方法对1997年7月至 1999年7月间30例GRT患者的31只患眼作回顾性分析。手术方法包括三通道睫状体平部玻璃体切割、膜剥离、视网膜切开与切除、全氟萘烷使用、眼内激光光凝、硅油或C₂F₆气体 填充。术中28只眼保留透明晶状体，术后追踪时间11～34个月(平均12.5个月)。结果GRT视网膜完全解剖复位29只眼，部分复位1 只眼，有效率为96.8%。硅油填充27只眼，平均6.0个月后行硅油取出，追踪6～19个月，26只眼视网膜全部复位,1只 眼失败。3只眼行白内障手术摘除，最终保留晶状体25只眼,其中并发晶状体后囊轻度混浊16 只眼。24只眼术后视力提高,占77.4%， 最好的矫正视力0.4。结论保留晶状体的玻璃体切割联合应用全氟萘烷液体及硅油填充可有效的提高伴有PVR的GRT 手术成功率及视力。(中华眼底病杂志,2001,17:93-95)

Lens-sparing vitreoretinal surgery for treatment of giant retinal tears

Objective To evaluate the effect of vitreoretinal surgery with lens sparing technique in treating the detachment with giant retinal tear(GRT) associated with proliferative vitreoretinopathy(PVR). Methods Thirty one consecutive eyes with GRT underwent vitrectomy were analysed retrospectively. Operative techniques included peeling of pre retinal membrane, injection of perfluorodecalin liquid, retinotomy and retinectomy,endolaser,and silicon oil or C 2F 6 gas tamponade. Lens sparing vitrectomy was performed in 28 phakic eyes. Follow up period ranged from 11 to 34 months. Results Anatomic retinal attachment was achieved intraoeratively in 29 eyes. In 16 eyes of 28 eyes with postoperative cataract formation,3 eyes underwent cataract surgery with or without intraocular lens implantation. The corrected final visual acuity ranged from 0.4 to 0.01. Conclusion Most phakic eyes of retinal detachment with GRT PVR can be successfully operated on with an outcome of improving the visual acuity by using techniques of lens sparing vitrectomy, perfluorodecalin liquid and silcone oil tamponade.