曲安奈德染色法在玻璃体切除手术中的应用

Triamcinolone acetonide in vitreous surgery

目的探讨曲安奈德(TA)染色法在玻璃体切除手术中协助辨别和清除残留玻璃体皮质和视网膜前膜的作用及效果。方法选取2008年6月至2010年5月,对我院85例(88只眼)玻璃体视网膜疾病行TA染色法玻璃体切除手术,切除中轴部玻璃体后,注入TA悬浊液染色玻璃体皮质和增生膜,切除残留的玻璃体皮质和视网膜前膜。术后随访时重点观察患者视力、眼压、白内障形成、玻璃体残留及视网膜复位情况。结果 85例(88只眼)术中注入TA后,残留的玻璃体皮质及视网膜前膜均能清晰地显示,容易辨认切除残留的玻璃体皮质和视网膜前膜位置和范围。术后随访观察6～12个月,81只眼(92.05%)视力有不同程度的提高,与手术前相比差异具有统计学意义(P<0.05)。术前40只眼视网膜脱离术后38只眼(95%)视网膜完全复位,术后未发现与TA相关的严重并发症。结论玻璃体切除手术中,应用TA染色玻璃体,可以清晰地显示残留的玻璃体皮质和视网膜前膜,有助于彻底切除玻璃体皮质和视网膜前膜,提高了手术的安全性和准确性。

Objective To discuss the role and effect of the Triamcinolone acetonide（TA） injection applied in vitreoretinal surgery for assisting to distinguish and remove residual vitreous cortex and epiretinal membrane.Methods After excision of the axial vitreous in 85 cases（88 eyes） of vitreoretinal diseases,TA was used to dye the vitreous and then vitrectomy technique was used to remove the residual vitreous and epiretinal membrane.During the follow-up,visual acuity,intraocular pressure,lens opacity,condition of the residual vitreous and the rate of retina reattachment were recorded.Results The residual vitreous and epiretinal membrane can be easily identified and removed with TA and vitrectomy technique.The location and coverage of the residual vitreous cortex and epiretinal membrane were clearly shown by TA dyeing.The visual acuity in 81 eyes（92.05%） was increased and retina was reattached in 38 eyes（95%） eyes after 6 to 12 months.there was a significant difference of preoperative and postoperative vision（P〈0.05）.Conclusion Residual vitreous cortex and epiretinal membrane can be easily identified and removed with TA dyeing and vitrectomy technique.The procedures were performed easily,surely and safely.