目的:通过对术前检查发现有或怀疑合并有视神经病变(主要指视盘缺血及萎缩)的患者采用两种不同的麻醉方式完成玻璃体切除手术后发生无光感的比率来选择一种相对安全的麻醉方式。方法:回顾分析80例80眼玻璃体切除手术患者的临床资料,这些患者术前或术中均发现视神经颜色淡,手术前分别采用球周浸润麻醉或球后阻滞麻醉后行玻璃体切除手术。检查手术结束时术眼有无光感,如发现无光感(多为一过性黑矇),采取积极治疗。结果:球后麻醉组术后无光感发生9例(22.5%),球周麻醉组未出现无光感。经积极治疗后,有8例恢复光感,1例经随诊观察为永久性失明。结论:合并有视神经病变的患者行玻璃体切除手术时采用球后麻醉有很高的黑矇几率,采用球周麻醉更安全。

AIM:To choose a relatively safe method of anesthesia by evaluating the ratio of no light perception preoperative for the patients with optic neuropathy (mainly referring to disc ischemia and atrophy) using two different methods on the vitrectomy. ·METHODS: Retrospectively analyzed the clinical data of 80 cases 80 eyes with pars plana vitrectomy in patients, all the patients had been confirmed that the color of optic nerve was light before or during surgery. They were used retrobulbar or peribulbar anesthesia across vitrectomy before surgery, and checked the light perception of the eye at the end of surgery. If no light perception, treat-ment was performed.·RESULTS: There are 9 cases (22.5%) of no light perce-ption in retrobulbar anesthesia group at the end of surgery, but none of them in peribulbar anesthesia group. After aggressive treatment, 8 cases returned to light perception and only one patient was permanent blindness by following up.·CONCLUSION: For patients with optic neuropathy to undergo vitrectomy surgery,using retrobulbar anesthesia have a high probability of amaurosis,peribulbar anes-thesia is safer than retrobulbar anesthesia.

R779.6