视网膜静脉阻塞性玻璃体积血的玻璃体切割手术疗效观察

Vitrectomy for vitreous hemorrhage secondary to retinal vein occlusion

目的观察玻璃体切割手术治疗视网膜静脉阻塞(RVO)性玻璃体积血的疗效。方法回顾性整理分析2006年3月至2009年6月在我院行玻璃体切割手术的玻璃体积血患者241例,其中RVO者28例(28只眼)(占11.6%)。随访6个月至2年观察患者的发病特点、视力预后、RVO相关并发症及手术相关并发症的发生情况。结果 26例患者术后视力较术前不同程度提高,占92.9%,2例术后视力保持不变,占7.1%。中央静脉阻塞11例,分支静脉阻塞17例。分支静脉阻塞术后视力好于中央静脉阻塞(P<0.0235)。玻璃体积血时间小于2个月的患者(10例)视力预后好于2个月后手术者(18例)(P<0.05)。玻璃体切除联合白内障超声乳化手术者较单纯玻璃体切除术者视力提高有统计学差异(P<0.05)。结论玻璃体切割手术是治疗RVO性玻璃体积血的有效方法。手术时机一般选在经药物治疗2～3个月积血仍不吸收时进行。白内障摘除联合玻璃体切割手术治疗合并白内障的RVO性玻璃体积血是安全有效的。

Objective To assess the effect of vitrectomy for vitreous hemorrhage secondary to retinal vein occlusion.Methods Retrospectively analyzed 241 patients with vitrectomy for vitreous hemorrhage which were 28 retinal vein occlusion patients（11.6 %）.Evaluated the sites,visual prognosis,retinal vein occlusion-related complications and surgery-related complications,following-up of 6 months to 2 years.Results 26 patients visual acuity increased（92.9%）,2 cases remained（7.1%）.11 cases of central retinal vein occlusion,17 cases of branch vein occlusion in the 28 patients.Postoperative visual acuity of branch retinal vein occlusion was better than the central retinal vein occlusion（Z = 1.1342,P = 0.0235）.Patients＇course less than 2 months（10 cases）,got better visual prognosis than more than 2 months（18 cases）（P 0.05）.Improved visual acuity in combined surgery with statistically significant difference than vitrectomy（P 0.05）.Conclusion Vitrectomy is an effective treatment for vitreous hemorrhage secondary to retinal vein occlusion.Surgery opportunity after 2 ～ 3 months when clots not absorbed.Cataract extraction combined with vitrectomy is safe and feasible for cataract combined with vitreous hemorrhage secondary retinal vein occlusion.