晚期急性视网膜坏死综合征的手术效果观察

目的评价急性视网膜坏死综合征视网膜脱离行玻璃体切除、硅油填充联合视网膜光凝术的手术效果。方法对10例（10眼）急性视网膜坏死综合征视网膜脱离进行经睫状体平坦部玻璃体切除和增生膜剥离术，术中氩激光光凝视网膜裂孔和残留的正常视网膜边缘，并行硅油填充术，3眼因晶状体浑浊同时行晶状体切除术，术后5～6个月取出硅油，硅油取出之前3周行赤道部的氩激光光凝，观察硅油取出后视网膜复位及视力状况。结果术后短期内（〈1月）视网膜全复位，随访14～26月，8眼视网膜复位良好，复位率80．00％（8／10），2眼因视网膜表面增生膜形成，视网膜再次脱离。术后视力：光感者1眼，手动者1眼，数指者3眼，0．05～0．1者3眼，0．12者2眼。结论现代玻璃体切除、硅油填充联合视网膜光凝术提高了急性视网膜坏死视网膜脱离的视网膜复位率，但因视网膜坏死结构破坏以致视力恢复较差。

Combined management of retinal detachment secondary to acute retina necrosis syndrome

Objective To evaluate the surgical efficacy of vitreorectomy combined with silicon oil tamponade and retinal photocoagulation for retinal detachment secondary to acute retinal necrosis syndrome. Methods 10 cases(10 eyes) which suffered acute retinal necrosis syndrome,developed to retinal detachment were underwent vitrectomy,membrane peeling,photocoagulation and silicon oil tamponading.3 eyes were underwent lensectomy because of the blerry lens.Equatorial retina was photocoagulated with argon laser at the third week before silicon oil was taken out. Results all retinal reattachment wereachieved in all eyes in the short time(less1 month),they were followed-up by 14-26months,8 eyes'retina reattached well,the rate was80%(8/10),2 eyes retina redetached because ofproliferated membrane on retinal surface.Post-operation vision acuity:light perception 2eyes,hand motion 1 eye,CF/20cm-CF/50cm 3eyes,0.05-0.1 3 eyes,0.12 2 eys. Conclusions The management of vitrectomy,silicon oil tamponade combined with retinal photocoagulation improved the retinal reattachment rate for retinal detachment secondary to ARNS,but post-operation vision acuity was low because of the retinal destruction of the disease.