中间型葡萄膜炎并发复杂性视网膜脱离的玻璃体手术治疗

目的:探讨中间型葡萄膜炎并发复杂性视网膜脱离的临床特征及玻璃体切除联合眼内填充术的治疗效果。方法:回顾性分析我院2000-01/2005-06收治的11例(共11眼)中间型葡萄膜炎并发复杂性视网膜脱离病例术前及术后详细的临床资料。所有患者均接受巩膜外环扎,玻璃体切除联合眼内填充术治疗,术中9眼行硅油充填,2眼填充长效惰性气体。术后随访12～66mo。结果:术后11眼均获视网膜良好复位及视力增进。随访期中有7眼于6～12mo取出硅油,硅油取出后2眼因周边部PVR或葡萄膜炎复发导致视网膜脱离复发,未取硅油的4眼(包括2只再手术眼)视网膜平伏。结论:中间型葡萄膜炎并发的复杂性视网膜脱离,尤其存在周边部纤维及血管膜的牵引时,玻璃体切除联合眼内填充术效果确切,周边部PVR和葡萄膜炎复发是术后限制视网膜复位的主要原因。

Therapeutic vitrectomy for intermediate uveitis associated with complicated retinal detachment

AIM:To investigate the clinical characteristic and the result of the pars plana vitrectomy of the intermediate uveitis associated with complicated retinal detachment.METHODS:The clinical data of 11 cases(11 eyes) with intermediate uveitis associated with complicated retinal detachment and treated with pars plana vitrectomy from Jan.,2000 to Jun.,2005 in The Second Xiangya Hospital of Central South University were retrospective analyzed.Nine eyes of cases were infused silicone oil and 2 eyes were infused inert gas into their vitreous bodies on the operation.The clinical data were observed during the follow-up of 12-66 months(mean 29 months) after the operation.RESULTS:All of eyes got retinal reattachment and visual acuity improvement after first surgery.Seven eyes had been done surgery of silicone oil removal,2 of them detached again in short time after the surgery of silicone oil removal because of PVR or recurrent uveitis.The retinal of 4 eyes which was not done the operation of silicone oil removal was flat.CONCLUSION:Pars plana vitrectomy accompany with intraocular tamponade is an effective way to manage intermediate uveitis associated with complicated retinal detachment.The factors which affect retine reattachment include severe PVR and recurrent uveitis.