预防性玻璃体切割手术治疗急性视网膜坏死综合征

Prophylactic vitrectomy for acute retinal necrosis syndrome

目的：探讨预防性玻璃体切割手术对急性视网膜坏死综合征的治疗效果。方法：患者26例33眼分为两组,常规治疗组20眼接受常规治疗,包括抗病毒治疗、视网膜脱离发生后给予玻璃体切割手术治疗;及时玻璃体切割手术组13眼给予抗病毒治疗及预防性玻璃体切割手术治疗。术后患者随访6＋48mo。结果：在常规治疗组,发生视网膜脱离11眼（55%）,眼球萎缩4眼（20%）,视力提高者3眼（15%）,预防性玻璃体切割手术治疗组,发生视网膜脱离1眼（8%）,视力提高者5眼（38%）。预防性玻璃体切割手术组视网膜脱离发生率较常规治疗组低（P〈0.05）。结论：预防性玻璃体切割手术可以有效地降低视网膜脱离的发生率,改善急性视网膜坏死综合征的预后。

AIM ： To evaluate the efficacy of prophylactic vitrectomy for acute retinal necrosis syndrome （ARNS）. METHODS： Twentysix patients （33 eyes） were retrospectively included in this study. The eyes were divided into 2 groups by treatment, including routine treatment, which consisted of antiviral medication and vitrectomy after retinal detachment （RD） （ n = 20）, and prophylactic vitrectomy, which consisted of antiviral medication and vitrectomy for the prevention of RD performed during the active inflammatory phase （n= 13）. The follow-up period ranged from 6 to 48 months. RESULTS： In the routine treatment group, retinal detachment occurred in 11 eyes （55%）, 4 eyes （20%） developed ocular atrophy, 3 eyes （15%） achieved increased visual acuity. In the prophylactic vitrectomy group, RD occurred in 1 eyes （8%）, 5 eyes （38%） achieved increased visual acuity. There was lower incident of retinal detachment in the prophylactic vitrectomy group than that in the routine treatment group （P〈0.05）. CONCLUSION ： Prophylactic vitrectomy can prevent RD and improve the prognosis of ARNS.