曲安奈德辅助玻璃体后皮质可视化在玻璃体切割术中的应用

The application of the triamicinlone acetonide as an aid to visualization of the vitreous during pars plana vitrectomy

目的探讨玻璃体切割术中应用曲安奈德(TA)辅助下使后皮质可视化造玻璃体后脱离的临床效果。方法对49例53眼行玻璃体切割术的患者,术中切除中央部玻璃体后,后极部注入0.2mlTA,在TA辅助下造玻璃体后脱离,观察玻璃体完全后脱离、后皮质残留及并发症发生的情况。结果53眼术中有8只眼发生玻璃体完全后脱离,发生率为15%,弥漫性玻璃体皮质残留29只眼,占55%;局限性玻璃体皮质残留16只眼,占30%;6只眼(11%)发生一过性高眼压,经治疗后好转,3只眼(6%)硅油填充眼出现晶状体混浊加重,无需进行手术。结论TA辅助下造玻璃体后脱离在玻璃体切割术中具有安全、手术效率高、并发症少等优点。

Objective To investigate the effects of TA as an aid visualization of the vitreous to make posterior vitreous detachment during pars plana vitrectomy. Methods Forty -nine patients （53 eyes） underwent PPV with TA, after removal anterior core vitreous,0. 2 ml（8 mg） TA was injected into the midvitreous cavity to visualize the posterior hyaloid. Completely posterior vitreous detachment, residual vitreous cortex, and complications were recoreded. Results all patients ,completely posterior vitreous detachment occurred in 8 eyes （ 15% ） ,widespread residual vitreous cortex in 29 eyes （55%） ,local residual vitreous cortex in 16 eyes （30%） ,6 eyes （ 11% ） elevation of the IOP between 25 and 45 mmHg,3 eyes （6%） had cataract progression,but had no significantly acuity effect. Conclusions The application of TA during pars plana vitrectomy is safety, helpful for improve surgery rate and less complications.