目的:通过临床研究评价在玻璃体切割术中荧光素钠染色残余皮质的有效性。探讨口服荧光素钠在玻璃体切割手术(vitrectomy)中的标志作用及术后眼压、视力同对照组相比较是否有统计学意义。减少玻璃体切割术中的并发症,及对视网膜和眼内其他组织是否产生毒副反应。方法:对2009-09/2010-09在哈尔滨医科大学第一临床医院附属眼科医院行玻璃体切割术的患者中,选取增殖型糖尿病视网膜病变(PDR)或视网膜脱离等病例,以往没有眼部后节手术史,且排除全身情况影响眼部疾病及不耐受手术的患者60例60眼。所有患者于玻璃体切割术前均行全身和眼局部的常规检查,术眼行视力、眼压、裂隙灯、眼底、B超,详细了解患眼术前角膜、前房、晶状体、玻璃体、视网膜等情况。将玻璃体切割术患者60例60眼分为治疗组和对照组,其中治疗组30眼术前空腹口服荧光素钠,对照组30眼术前未口服荧光素钠。术后进行视力、眼压、裂隙灯、眼底、B超,术后随诊1mo。通过随访,观察两组视力、眼压的变化,分析其统计学意义。结果:在玻璃体切割术中,荧光素钠分散在玻璃体皮质中,可以清楚地显示残留玻璃体皮质的部位和范围,易于剥除残留玻璃体的皮质,两组在视力、眼压的变化差异无统计学意义。结论:荧光素钠可以清晰地标志残留玻璃体,具有手术安全性,未见明显不良反应。减少医源性视网膜裂孔发生率,有利于保护和恢复视功能,且对视网膜及眼内其他组织无毒性。

AIM:To evaluate the efficacy of fluorescein sodium on dyeing residual vitreous during the vitrectomy.To discuss the effect of fluorescein sodium which can demarcate the residue vitreous on vitrectomy and whether there are statistical significance on postoperative intraocular pressure(IOP) and visual acuity with comparison group and whether it can decrease the complications or not during vitrectomy.To investigate whether the fluorescein sodium can produce retinal toxicity or not through clinical study.METHODS:The study included 60 cases (60 eyes) who underwent vitrectomy in the first clinical hospital of Harbin medical university from September,2009 to September,2010.The 60 cases were proliferative vitreous retinopathy or detachment of retina,without operation experience of posterior segment in the past.There were not any condition affecting the ocular disease.All the patients could endure the vitrectomy,and they had had common body examination and ocular examination.All eyes were examined by slit-lamp biomicroscopy,binocular indirect ophthalmoscopy,B-scan and electroretinography before operation.The condition of cornea,anterior chamber,lens,vitreous body,retina,etc.were learned about.60 cases with vitrectomy were divided into study group and control group.Fluorescein sodium injection was taken orally in 30 eyes of study group before the surgery.Fluorescein sodium was not used in the 30 eyes of control group.All eyes were examined by slit-lamp biomicroscopy,binocular indirect ophthalmoscopy,B-scan after operation.The mean follow-up was 1 month after operation,visual acuity and IOP of the two groups were compared and analyzed.RESULTS:The location and coverage of the residual vitreous cortex were clearly shown by fluorescein sodium and the residual vitreous cortex was conveniently to be recognized and removed There was neither difference in visual acuity,IOP before and after operation nor obvious ocular complications related to fluorescein sodium,and no evident differences in comparison between the two groups.CONCLUSION:Location and coverage of the residual vitreous cortex were clearly shown by fluorescein sodium.It has the surgery safety,without obvious adverse reactions,and decreases the complicating diseases such as incidence of iatrogenic retinal break.It is profitable to protect and recover visual function without intraocular toxicity.

R779.6