玻璃体手术治疗合并玻璃体积血的Terson综合征

目的观察玻璃体手术治疗伴有玻璃体积血的Terson综合征的术中情况及效果。方法回顾性分析接受玻璃体手术的伴有玻璃体积血的Terson综合征9例（16眼）的临床资料。所有患眼均行玻璃体切除手术,6眼联合C3F8惰性气体填充,对于同时伴有视网膜前膜者,术中加用吲哚氰绿染色,将视网膜前膜剥除。手术后随访2～24个月,平均18个月。结果术中发现不完全性玻璃体后脱离者10眼（62.50%）,视网膜前膜形成者5眼（31.25%）,同时合并有视网膜下出血者3眼（18.75%）,视神经萎缩者1眼（6.25%）。术后视力≥0.5者8眼（50.00%）,0.3～0.4者4眼（25.00%）,0.02～0.2者4眼（25.00%）。术后随访观察期间,均未发现视网膜脱离。1眼术后3个月出现继发性黄斑前膜,2眼术后出现并发性白内障。结论玻璃体手术治疗Terson综合征具有很好的临床效果,能明显改善视力,减少并发症的发生,提高患者生活质量。

Vitrectomy for the treatment of Terson syndrome with vitreous hemorrahge

Objective To observe the surgical condition of Terson syndrome and the therapeutic effect of vitrectomy for it. Methods Retrospectively analyzed 9 cases （ 16 eyes） diagnosed as Terson syndrome with vitreous hemorrahge. All of them had undergone vitrectomy surgery, 6 cases combined with adjunct of C3F8, We peeled the epiretinal membrane by means of staining with ICG. They were followed up for 2 months -2 years, meanly 18 months. Results In all patients underwent operations, incomplete posterior vitreous detachment （PVD） was found in 10 eyes （62.5%） , epiretinal membrane was formed in 5 eyes （31.25% ） , and subretinal hemorrhage occurred in 3 eyes （ 18.75% ） , optic atrophy in one eye（6.25% ）. Visual acuity of 0.5 or better was achieved in 8 eyes （50%） , visual acuity of 0.3 -0.4 was achieved in 4 eyes （25%） ,visual acuity of 0.02 -0.2 was achieved in 4 eyes （25%）. During the follow-up,no retinal detachment occurred,one eye （6.25%） occurred in macular epiretinal membrane, 2 eyes （ 12.5 % ） developed lens opacity. Conclusion The vitrectomy is effective for Terson syndrome, with visual improvement, reduction of complications and improvement of the quality of the patient＇s living condition.