玻璃体切除治疗复发性出血性玻璃体视网膜疾病

目的探讨玻璃体切除术对复发性出血性玻璃体视网膜疾病的临床效果。方法对43例(44眼)玻璃体积血施行三通道经睫状体平坦部玻璃体切除术,联合膜剥离,水下透热,眼内光凝(或经巩膜冷凝),并根据病情选用眼内长效填充材料。结果视网膜静脉阻塞18眼,外伤性玻璃体积血9眼,视网膜裂孔致玻璃体积血6眼,静脉周围炎5眼,增生性糖尿病视网膜病变3眼,蛛网膜下腔出血合并玻璃体积血(综合症)2眼,老年性黄斑变性1眼。术后随访2～24月,44眼视力均有不同程度的提高,随访视力较术前相比差异有统计学意义(P<0.05),视力0.05以上者36眼(81.82%),0.2～0.8者27眼(61.36%)。结论复发性出血性玻璃体视网膜疾病经药物治疗无效,B超显示出现玻璃体后脱离或B超显示伴有牵引性视网膜脱离者,玻璃体切除术是消除玻璃体积血并使视网膜复位的有效方法。

Vitrectomy on recurrent hemorrhagic vitreoretinal diseases

Objective To study the clinical curative of vitrectomy for recurrent hemorrhagic vitreoretinopathy.Methods 43 cases(44 eyes) of vitreous hemorrhage were investigated.All eyes were performed routine three-way joint vitrectomy combined with peeling membrane,diathermy,retinal photocoagulation(or cryotherapy) and long-term temponade according to patient's condition.Results Retinal vein occlusion in 18 eyes,traumatic vitreous hemorrhage in 9 eyes,rhegmatogenous vitreous hemorrhage in 6 eyes,retinal periphlebitis in 5 eyes,proliferative diabetic retinopathy in 3 eyes,subarachnoid hemorrhage combined with vitreous hemorrhage in 2 eyes and senile macular degeneration in 1 eye.Flow-up 2-24 months after operation,All the eyes were improved in visual acuity to certain level.The best-corrected visual acuity was >0.05 in 36 eyes(81.81%),0.2~0.8 in 27 eyes(61.36%),there was statistical significance compared to preoperation(p<0.05).Conclusion drug treatments are no effects for recurring hemorrhagic vitreoretinopathy.If comply with posterior detachment of vitreous and retina detachment,vitrectomy is an effective method for hemorrhage extraction and retina reposition.