曲安奈德染色玻璃体辅助玻璃体切割术治疗孔源性视网膜脱离

Surgical results of triamcinolone acetonide assisted pars plana vitrectomy in rhegmatogenous retinal detachment patients

目的探讨曲安奈德(TA)染色玻璃体辅助玻璃体切割术在治疗孔源性视网膜脱离中的应用价值。设计回顾性病例系列。研究对象北京英智眼科医院2006～2009年孔源性视网膜脱离经睫状体平坦部玻璃体切割术的患者425例(428眼)。方法比较TA辅助组(302例,304眼)与未进行TA辅助的对照组(123例,124眼)两组间术前术后的视力及并发症差异(χ2检验)。TA组及对照组平均随访分别为(18.3±6.3)、(21.3±4.2)个月。主要指标最佳矫正视力,术后并发症。结果 TA组术后视力改善与对照组比较差异有统计学意义(P<0.05)。TA组术后视网膜复发性脱离、黄斑前膜的复发率较对照组明显减少(P均<0.05)。术后一过性眼压增高两组未见明显差异(P>0.05)。结论使用TA染色的玻璃体切割视网膜复位手术能够降低术后复发性视网膜脱离和视网膜前膜的发生率,而且未增加手术并发症。

Objective To evaluate the value of triamcinolone acetonide （TA） assisted pars plana vitrectomy in patients with rhegmatogenous retinal detachment. Design Retrospective case series. Participants 425 cases （428 eyes） with rhegmatogenous retinal detachment, who were pertormed vitrectomy during 2006 to 2009 from Beijing Intech Eye Hospital. Methods Chi-square test was used to compare the differences of the visual acuity and postoperative complications between with TA and without TA. The duration of the follow-up in TA group and without TA group was （18.3±6.3） and （21.3±4.2） months, respectively. Main Outcome Measures Preoperative and postoperative best corrected visual acuity, and postoperative complications. Results The visual acuity in TA group was significantly improved compared with the control group （P〈0.05）. The rates of recurrent retinal detachment and epiretinal membrane in TA group were lower than in control group （P〈0.05）. Intraocular pressure increased temporarily after surgery, and there was no statistical significance between the two groups. Conclusion The use of triamcinolone acetonide may decrease the rate of posteroperative recurrent retinal detachment and epiretinal membrane and complications are acceptable after surgery.