25G微创玻璃体切除联合内界膜剥除治疗PVR-C级视网膜脱离

目的:观察25G微创玻璃体切除联合内界膜剥除治疗增殖性玻璃体视网膜病变(PVR)-C级视网膜脱离的效果。方法:收集2015-08/2018-07在我院就诊的PVR-C级视网膜脱离患者37例37眼,对所有患者行25G微创玻璃体切除联合硅油填充术治疗,术中吲哚菁绿染色后剥除血管弓大小范围内界膜。3~6mo根据视网膜复位情况行硅油取出,术后随访12mo,观察视力、眼压、视网膜复位、黄斑前膜情况并进行回顾性分析。结果:术后视力均有不同程度提高;术后2wk内眼压增高者6眼,经过治疗,眼压均恢复正常;所有患者到随访末期均未出现黄斑前膜;2眼因下方视网膜周边部出现PVR致再次视网膜脱离,余35眼均成功取出硅油。结论:25G微创玻璃体切除联合内界膜剥除治疗PVR-C级视网膜脱离安全有效,并有效防止了黄斑前膜的出现。

25G micro-invasive vitrectomy combined with internal limiting membrane peeling in the treatment of PVR-C retinal detachment

AIM:To observe the effect of internal limiting membrane exfoliation in the treatment of PVR-C retinal detachment.

METHODS: A total of 37 cases(37 eyes)of PVR-C retinal detachment were collected from August 2015 to July 2018.All eyes were treated with 25G invasive vitrectomy combined with silicone oil filling. The internal limiting membrane was removed after indocyanine green staining,and the removal size of the inner boundary membrane to the upper and lower vascular arch. Silicone oil was taken out of the retina in 3-6mo. Followed up for 12mo after the first operation, the visual acuity, intraocular pressure, retinal reattachment and the formation of the macular membrane were observed and analyzed retrospectively.

RESULTS: The vision of all patients was improved. The intraocular pressure of 6 eyes increased within 2wk after operation, and the intraocular pressure returned to normal after treatment. All patients were followed up for 1a, macular membrane did not occur. Retinal detachment occurred again in 2 eyes due to PVR of the anterior retina. The remaining 35 eyes, silicone oil were successfully removed.

CONCLUSION: 25G micro-invasive vitrectomy combined with internal limiting membrane peeling is safe and effective in the treatment of this kind of disease, and effectively prevent the appearance of the macular anterior membrane.