非接触双目间接眼底显微镜联合前房灌注在复杂玻璃体视网膜病变术中的应用

The application of binocular indirect ophthalmomicroscope combined with anterior chamber maintainer in vitrectorny for complicated vitreoretinopathy

目的观察使用非接触双目间接眼底显微镜（BIOM）联合前房灌注系统（ACM）行玻璃体切割术处理复杂玻璃体视网膜病变的临床疗效。方法6例（6只眼）复杂玻璃体视网膜病变行玻璃体切割术时，为了避免医源性的脉络膜视网膜损伤，采用前房灌注来维持眼压，晶状体摘除及前部玻璃体切割后，切换至BIOM行玻璃体视网膜手术。临床随访3-11月，评估手术疗效及并发症。结果6例BIOM联合ACM的玻璃体切割术在操作中未见明显困难。术后5例视力提高，1例无变化。主要长期并发症为低眼压、前部PVR、视网膜前膜。4例行硅油取出术后，视网膜在位。结论采用BIOM联合ACM行玻璃体切割术治疗复杂玻璃体视网膜病变安全、有效，在实践中具有可行性。

Objective To evaluate the clinical results of vitrectomy by using binocular indirect ophtha/momicroscope （BIOM） combined with anterior chamber maintainer （ACM） for complicated vit- reoretinopathy. Methods Six cases （6 eyes） of complicated vitreoretinopathy were undergone vitrecto- my, during which ACM was used to maintain intraocular pressure and prevent from iatrogenic injury of choroid and retina. After lens and anterior vitreous removal, vitrectomy was completed through a BIOM observation system. The follow-up time ranged from 3 months to 11 months. The effects and complications were analyzed. Results No obvious drawback was noticed during the 6 cases vitreoto- my by using BIOM and ACM combination. The visual acuities improved in 5 cases and remained stable in 1 case after operation. The major long-term complications were hypotony, epiretinal mem- brane, and anterior proliferative vitreoretinopathy. Retinal reattached in 4 cases after silicone oil re- moval. Conclusions The vitrectomy combined BIOM with ACM is effective and safe for complicat- ed vitreoretinopathy, and clinical results ascertained the practical feasibility of it.