玻璃体积血合并视网膜裂孔或脱离的玻璃体切割手术疗效观察

Effect observation of pars plana vitrectomy for the treatment of vitreous hemorrhage complicated retinal hole or detachment

摘要:

目的:探讨玻璃体积血合并视网膜裂孔或脱离采用玻璃体切割手术治疗的疗效及必要性。 方法:对28例28眼玻璃体积血合并视网膜裂孔或脱离患者采用玻璃体切割手术治疗，观察治疗前后视力改变，并分析玻璃体积血与视网膜裂孔或脱离的关系。 结果:不同原因所导致的玻璃体积血28例中，7例术前B超未发现视网膜脱离，而在术中发现3例裂孔，4例伴裂孔周围浅脱；28例患者术后视力（包括术后随访最佳视力）均有不同程度的提高，数指/眼前以上者27例(96%)，≥0.05者20例(71%)，≥0.3者5例(18%)，手术前后视力比较，具有统计学差异(P＜0.05)。 结论:玻璃体积血合并视网膜裂孔或脱离采用玻璃体切割手术治疗，安全有效，且能尽早发现视网膜裂孔及浅脱离，阻止视网膜脱离进一步扩大。

Abstract:

AIM: To discuss the effect and necessity of pars plana vitrectomy(PPV) for the treatment of vitreous hemorrhage complicated retinal hole or detachment. METHODS: Totally 28 cases(28 eyes) with vitreous hemorrhage complicated retinal hole or detachment were treated by PPV. The change of visual acuity was observed pre- and postoperatively and the relationship between vitreous hemorrhage and detachment was analyzed. RESULTS: In 28 cases with vitreous hemorrhage caused by various reasons, 7 cases occurred no retinal detachment from preoperative B ultrasound, 3 cases found retinal hole in intraoperation, 4 cases accompanied peri-hole shallow detachment. Postoperative visual acuity of 28 cases (including postoperative follow-up best-corrected visual acuity) improved in various degree, better than counting finger or before eye in 27 cases(96%),≥0.05 in 20 cases(71%),≥0.3 in 5 cases(18%).There was statistical significant difference between pre- and postoperation(P＜0.05). CONCLUSION: It is safe and effective for vitreous hemorrhage complicated retinal hole or detachment treated by PPV, and can find retinal hole and shallow detachment as soon as possible so as to avoid further enlargement of retinal detachment.