预防性脉络膜视网膜切除治疗外伤性视网膜嵌顿

Prophylactic chorioretinectomy for traumatic retinal incarceration

目的:探讨预防性脉络膜视网膜切除术治疗外伤性视网膜嵌顿的治疗效果。方法:应用玻璃体切割、预防性脉络膜视网膜切除、眼内激光、眼内充填术,部分病例联合巩膜外加压和巩膜环扎治疗伴视网膜脱离的外伤性视网膜嵌顿69例69眼。结果:11±6(4～27)mo随访期内,最终视网膜复位率91%(63/69),增生性玻璃体视网膜病变发生率14%(10/69),眼球保存率99%(68/69)。术前视力<0.1的占84%(58/69),最终最佳矫正视力≥0.1的占45%(31/69),术后视力有不同程度提高。结论:采用玻璃体视网膜手术是治疗外伤性视网膜嵌顿的有效方法,施行预防性脉络膜视网膜切除术是解除视网膜脉络膜嵌顿的关键,可显著提高视网膜脱离复位率,降低增生性玻璃体视网膜病变发生率。

·AIM：To evaluate the effectiveness of prophylactic chorioretinectomy for traumatic retinal incarceration.·METHODS：Retrospective,consecutive interventional case series of 69 eyes with traumatic retinal incarceration were treated with a 20 gauge three-port pars plana vitrectomy.The operative technique included prophylactic chorioretinectomy,endophotocoagulation,intraocular tamponade and scleral buckling procedure.·RESULTS：Sixty-nine eyes of 69 patients were followed for median of 11±6（range from 4 to 27）months.The rate of retinal reattachment was 91%（63/69）.The rate of proliferative vitreoretinopathy was 14%（10/69）.Best-corrected visual acuity（BCVA）≥0.1 occurred in 31 patients（45%）.Globe survival rate was 99%（68/69）.·CONCLUSION：Prophylactic chorioretinectomy is a surgical option that may increase the rate of final retinal reattachment and decrease the rate of proliferative vitreoretinopathy for traumatic retinal incarceration.·