摘要
目的探讨不同时机的玻璃体切割术对急性视网膜坏死综合征(ARNs)视力预后的影响。方法对2009年9月至2011年10月我院收治的ARNs患者5例(7只眼)的进行回顾性分析,年龄47～63岁,平均(55.2±6.5)岁,男女比例3:2。术前已明确伴有视网膜脱离2例(2只眼)接受玻璃体切割联合晶状体切割及硅油填充术。抗病毒药物治疗后3例(3只眼)眼部体征加重,未发生视网膜脱离2例(2只眼)接受预防性玻璃体切割术,另1例(1只眼)玻璃体切割术中发现有视网膜脱离,联合硅油填充术。后发作的2例(2只眼)接受抗病毒药物治疗及外路视网膜光凝。结果术后随访6个月至2年,硅油填充3只眼半年左右均行硅油取出术,视力无改善或下降,有1只眼视网膜脱离复发。预防性玻璃体切割术2只眼及后发作的2只眼视网膜均保持附着,视力恢复均超过治疗前。结论 ARNs经抗病毒药物治疗后若眼部体征仍加重,早期预防性玻璃体切割术可以避免视网膜脱离的发生,视力预后更好。
Objective To analyze visual outcome in acute retinal necrosis syndrome （ ARNs ） by vitrectomy at dif- ferent opportune moment. Methods A retrospective study was carded out in 5 hospitalized patients （ 7 eyes） with acute retinal necrosis syndrome during the period of september, 2009 to Octobe, 2011, The age ranged from 47 to 63 years old with average 55.2 ± 6.5. Two cases （2 eyes） with retinal detachment confirmed preoperative received vitrectomy com- bined with lens extraction and silicone oil tamponade. Ocular symptoms of 3 cases （ 3 eyes ） were aggravated during anfivi- rel therapy. Prophylactic vitrectomy were performed on 2 cases （ 2 eyes） without retinel detachment, while silieone oil tam- ponade were performed on another cases （ I eye ） which retinal detachment was found during vitrectomy. Two cases （ 2 eyes ） attacked sequentially were treated with antivira] therapy and laser photocoagulation. Results The follow-up period ranged from 6 to 24 months. Three eyes with silicone oil tamponade underwent silicone oil removal at a approximate interval of 6 months, whose visual acuity had no improvement, and recurrent retinal detachment developed in 1 eye. Retina attached in 2 eyes received prophylactic vitrectomy and 2 eyes attacked sequentially, which visual outcome was better than before treat- ment. Coltdllslolt Timely prophylactic vitrectomy was effective in preventing the development of retinal detachment and was associated with better recovery of visual function in eyes with ARNs,which antiviral therapy was invalid.
出处
《临床眼科杂志》
2013年第3期233-235,共3页
Journal of Clinical Ophthalmology
