视网膜复位术后黄斑前膜形成的早期药物治疗

Therapy for macular epiretinal membrane formation in the early stage after retinal detachment surgery

目的探讨尿激酶联合地塞米松结膜下注射治疗视网膜复位术后早期并发黄斑前膜的效果.方法6例6眼原发性(裂孔源性)视网膜脱离复位术后早期黄斑前膜形成,黄斑前膜薄如玻璃纸样,视网膜表面波纹,中心凹旁血管扭曲,视物变形、视力下降.药物治疗行尿激酶联合地塞米松结膜下注射,共2～3次.随访观察治疗前后视力改变、视物变形改善、眼底病变进展情况及视觉电生理变化.随访时间为6月至3年.结果4例治疗后视物变形改善,视力提高.2例无变化.5例的眼底病变无进一步发展,1例视物变形,视力下降,眼底黄斑前膜发展,网膜皱摺,血管走向变形.结论视网膜复位术后黄斑前膜形成早期,尿激酶联合地塞米松结膜下注射可部分控制病变进一步发展.严重的黄斑前膜需通过玻璃体手术加以剥除,恢复黄斑区的解剖形态,以提高视力,改善视物变形.

Objective To study the effect of subconjunctival injection urokinase combined with dexamethasone for macular epiretinal membrane formation in the early stage after retinal detachment surgery. Methods Six eyes with macular epiretinal membrane formation in the early stage after rhegmatogenous retinal detachment. It showed retinal wrinkles and vessel tortuosity. Patients felt visual distortion and vision lost. Subconjunctival injection urokinase combined with dexamethasone was performed 2-3 times. Observed visual acuity, visual distortion, retinal disorder and electrophysiologic changes. Followed from six months to three years, Results There were four eye＇s visual acuity and visual distortion improved; two eyes without any change. Five eyes with retinal disorder did not feel any progress. One eye＇ s vision declined, visual distortion, macular epiretinal membrane progressed so that causes retinal wrinkles and vessel tormosity. Conclusion Subconjunctival injection urokinase combined with dexamethasone for macular epiretinal membrane formation in the early stage after retinal detachment surgery can control some cases in progression. Severe macular epiretinal membrane needs surgical peeling to restore the normal macular anatomic structure so that to improve visual acuity and visual distortion.