利水渗湿中药联合23G玻璃体切除手术治疗玻璃体黄斑牵引综合征临床观察

Therapeutic effect of using 23-g vitrectomy associating decoction of removing dampness and promoting diuresis treating vitreomacular traction syndrome

目的探讨利水渗湿中药联合23G玻璃体切割手术治疗玻璃体黄斑牵引综合征的临床疗效。方法对照研究玻璃体黄斑牵引综合征患者27例,其中13例(13眼)单纯采用20G玻璃体切割联合黄斑前膜剥除术治疗,14例(14眼)采用23G手术剥除黄斑前膜联合术后运用利水渗湿中药,对比两组在治疗前后患者视力、眼压、黄斑视网膜厚度、黄斑区总容积和术中术后并发症,评价两种治疗方法的临床疗效和安全性。结果 27例玻璃体黄斑牵引综合征患者均顺利完成手术,术后1个月两组视力、黄斑视网膜厚度、黄斑区总容积比较差异无统计学意义,治疗3个月后,中西医联合治疗组患者平均视力明显好于单纯玻璃体手术患者组(P<0.05),黄斑视网膜厚度平均为(275±187)μm、黄斑区总容积平均为(7.58±4.77)μm2,二者均明显小于20G玻璃体切除手术组。结论利水渗湿中药联合23G玻璃体切除手术治疗黄斑牵引综合征疗效显著,其特点为手术创伤小、时间短,术后恢复快。

OBJECTIVE To estimate the clinical effect of 23-g vitrectomy associating with decoction of removing dampness and promoting diuresis treating vitreomacular traction syndrome contrast simple 20-g vitrectomy group.METHODS Contrast the vision,intraocular tension,macular retina thickness,macula volume and complication in and after operation of two groups.Group one included 13 eyes of 13 patients treating with simple 20-g vitrectomy peeling macular frontal membrane.Group two included 14 eyes of 14 patients treating with 23-g vitrctomy peeling macular frontal membrane and using decoction of removing dampness and promoting diuresis after operation.RESULTS Twenty-seven patients completed the operation successfully.The outcome of vision,macular retina thickness and macular volume had no statistical significance one month after operation.At the 3rd month after oper ation the vision obviously rose of group two with decoction treatment contrast to group one,the average macular retina thickness was 275±187μm and macular volume was 7.58±4.77μm2of group two.It was significantly less than that of group one.CONCLUSIONS The clinical therapeutic effect of 23-g vitrectomy associating with decoction of removing dampness and promoting diuresis treating vitreomacular traction syndrome was significant and the feature was less damage,shorter operation time and faster recovery after operation.