显微内窥镜下超全视网膜光凝治疗虹膜新生血管探讨

目的 探讨眼显微内窥镜在玻璃体切除术后虹膜新生血管超全视网膜光凝中的作用.方法 回顾16例16只眼玻璃体切除术后虹膜新生血管在内窥镜下行超全视网膜光凝的临床资料.选择玻璃体切除术后,术中行部分视网膜光凝.病因为糖尿病视网膜病变8只眼、视网膜中央静脉阻塞6只眼、视网膜血管炎2只眼;10眼人工晶体眼、6只眼无晶体眼,瞳孔难以散大;2只眼眼压高,14只眼正常;虹膜新生血管Ⅰ期14只眼、Ⅱ期2只眼.三腔内窥镜进入眼内进行视网膜超全光凝.对比观察虹膜新生血管消退情况、眼压、视力变化及并发症出现,随访3月至3年.结果 15眼1次超全视网膜光凝术后3个月虹膜新生血管消退,1眼继发新生血管性青光眼,眼压术后恢复正常,视力治疗前后无明显变化,未见虹膜损伤、视网膜脱离、眼内炎等手术并发症.结论 超全视网膜光凝是治疗虹膜新生血管的有效手段.玻璃体切除术后人工晶体或无晶体眼瞳孔难以散大情况下,显微内窥镜下的眼内视网膜光凝是可靠选择,可作为眼外视网膜光凝的有力补充.

Argon laser panretinal photocoagulation under microendeoscopy for iris neovascular after vitrectomy

Objective To explore the effect of argon laser panretinal photocoagulation under microendeoscopy for iris neovascular patients who have been run pars plana vitrectomy.Methods 16 cases (16eyes) with iris neovascularization who undergone argon laser panretinal photocoagulation under microendeoscopy after pars plana vitrectomy were evaluated retrospectively.All cases have been run vitrectomy and part retinal photocoagulation.And among them,there were diabetic retinopathy in 8 eyes,central retinal vein occlusion in 6 eyes and retinal vasculitis in 2 eyes.There were 10 pseudophakic eyes and 6 aphakic eyes.The intraocular pressure(IOP)in 2 eyes were high and others were normal.The Ⅰ stage of iris neovascularization were 14 eves and the Ⅱ stage of iris neovascularizafion were 2 eyes.All cases have been run argon laser panretinal photocoagulation under microendeoscopy.Neovascularization of iris,visual acuity,IOP and postoperative complications were observed comparatively.The follow up time was 3-36 months.Results In 15 of 16 eyes.new vessels in the iris completely disappeared 3 months after photocoagulation.The IOP in 1 eye with neovascular glaucoma was controlled after operation.There were no significant difference in visual acuity between preoperative and postoperative.Postoperative complication was not observed such as iris injury,retinal detachment and endophthalmitis.Conclusion It suggests that argon laser panretinal photocoagulation is a safe and effective therapeutic modality for iris neovascular after pars plana vitrectomy.It also suggests that argon laser panretinal photocoagulation under microendeoscopy is a reliable choice and powerful complement for the pseudophakic and aphakic eyes after pars plana vitrectomy.