急性视网膜坏死综合征视网膜切开的疗效评价

目的　观察玻璃体切除视网膜切开术在急性视网膜坏死综合征 (acuteretinalnecrosissyndrome ,ARN)的临床疗效。方法　 12例急性视网膜坏死伴有增生性玻璃体视网膜病变 (proliferativevitreoretinopathy ,PVR)的视网膜脱离 ,使用常规的玻璃体切除术不能使视网膜得以复位 ,对坏死的视网膜及呈网状裂孔的视网膜进行 2 0°～ 3 60°切开并行全氟化碳液体填充、眼内激光光凝、硅油填充等治疗。结果　术毕 12例均取得视网膜解剖复位 ,其中 1例因继发性青光眼中途取出硅油而放弃治疗 ,10例 6～ 8月后取出硅油 ,随访 6月 8例视网膜完全复位 ,2例取硅油后视网膜脱离复发 ,1例因并发性白内障无法观察眼底情况。结论　视网膜切开术对急性视网膜坏死有一定的疗效。

The clinical observation for retinotomies in the treatment of acute retinal necrosis

Objective To observe the clinical curative effect of retinotomy in treatment of acute retinal necrosis syndrome.Methods Twelve-eyes were treated with vitrectomy and retinotomy for acute retinal necrosis with retinal detachment. Retina can't be attached by using routine vitrectomy.After 20-degree to 360-degree retinotomy for necrotic retina and reticular retina,perfluorocarbon liquid was injected into vitreous cavity.Intraocular laser and silicone oil tamponade were performed.Results Retinal anatomical attachment were obtained in 12 eyes at the end of the operation.Silicone oil was removed from 1 eye because secondary glaucoma within 1 month.After follow-up of 6 months,the retina were completely attached in 8 eyes when silicone oil was removed.Recurrent retinal detachment occurred in 2 eyes after silicone oil was removed.Complicated cataract occurred in 1 eye.Conclusion Retinotomy is a useful method for the therapy of acute retinal necrosis syndrome.