玻璃体切除治疗视网膜静脉阻塞性玻璃体出血的疗效分析

Vitrectomy for vitreous hemorrhage caused by retinal vein occlusion

目的研究玻璃体切除术治疗视网膜静脉阻塞性玻璃体出血的疗效及其手术并发症。方法回顾性分析１９９２年４月至１９９６年１２月我院行玻璃体切除术的４７例患者，并对３０例进行了随访。结果（１）８０％患者视力提高，分支静脉阻塞（ｂｒａｎｃｈｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＢＶＯ）组视力好于中央静脉阻塞（ｃｅｎｔｒａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＣＶＯ）组，Ｐ＜０．０５。（２）术中并发症为医源性裂孔，术后并发症中晶体混浊、玻璃体再出血、视网膜脱离和高眼压较多见。（３）术中行眼内激光治疗的患者，玻璃体再出血发生率低，Ｐ＜０．０５。结论玻璃体切除术使半数以上患眼重新获得有用视力，术中行眼内激光治疗能预防术后玻璃体再出血。

Objective To evaluate the efficacy and complications of vitrectomy for vitreous hemorrhage after retinal vein occlusion. Methods We retrospectively studied 47 patients (47 eyes) having undergone vitrectomy during the period from April, 1992 to December, 1996. Follow up was made on 30 patients. Results (1) Visual acuity was improved postoperatively in 80% of the eyes. The patients with branch vein occlusion achieved more favorable final vision than those with central retinal vein occlusion ( P <0.05). (2) The most common complications were lens opacity, recurrent vitreous hemorrhage, iatrogenic rhegmatogenous retinal detachment and glaucoma. (3) Patients treated with endophotocoagulation had a lower rate of recurrent vitreous hemorrhage ( P <0.05). Conclusions (1) More than half of the petients can achieve ambulant vision after vitrectomy for vitrous hemorrhage induced by retinal vein occlusion. (2) Recurrent vitreous hemorrhage can be effectively prevented by endophotocoagulation during the operation.