玻璃体切除术治疗急性视网膜坏死所致视网膜脱离

Clinical observation for the treatment of acute retinal necrosis with retinal detachment by vitrectomy

目的:观察玻璃体切除术治疗急性视网膜坏死所致视网膜脱离的临床效果。方法:回顾性分析2003-01/2008-01期间在我院行玻璃体切除术的急性视网膜坏死所致视网膜脱离患者15例(15眼),分析其视网膜脱离的特点,观察其临床治疗效果。结果:所有患者均行玻璃体切除术,联合行巩膜外环扎术10例,术中均行硅油填充术,术中视网膜出血2眼,术后并发性白内障4眼,高眼压1眼,低眼压1眼,取硅油后视网膜脱离复发1眼。术后6mo患眼最佳矫正视力除1眼放弃治疗外其余14眼均有不同程度地提高。结论:玻璃体切除术是治疗急性视网膜坏死综合征所致视网膜脱离的最佳治疗方法,对于部分病例,需联合行巩膜外环扎术。

AIM. To investigate the clinical effects of vitrectomy in the management of retinal detachment following the acute retinal necrosis （ARN）. METHODS： The clinical data （ including clinical features and effectiveness） of 15 patients （15 eyes） with retinal detachment diagnosed as acute retinal necrosis and were treated in our hospital from January 2003 to January 2008, were retrospectively analyzed. RESULTS： All patients were operated by vitrectomy and silicone oil tamponade. Of them, 10 patients were combined with scleral encircling. The visual acuity increased in 14 eyes in the surgical group. Retinal hemorrhage occurred in 2 eyes. Complicated cataract occurred in 4 eyes. Intraocular hypertension occurred in 1 eye. Intraocular hypotension occurred in 1 eye. Recurrent retinal detachment occurred in 1 eye in which the silicone oil had been removed. CONCLUSION： Retinal detachment is still a severe complication of ARN. Vitrectomy and silicone oil tamponade seems the most effective treatment option for the acute retinal necrosis. For some cases, vitrectomy combined with scleral encircling is necessary.