激光诱导脉络膜视网膜静脉吻合术对非缺血型视网膜静脉阻塞42眼的临床观察

Clinical observation of 42 cases of norischemic retinalvein occlusion by laser-induced chorioretinal venous anastomosis

目的 探讨激光诱导脉络膜视网膜静脉吻合治疗非缺血型视网膜静脉阻塞（ retinal occlusion,RVO）的效果,安全性及影响因素.方法 对42例42眼伴进行性视力下降的非缺血型RVO行上述手术患者的视力、眼底表现荧光素眼底血管造影（Fundus fluorescein angoigrapng,FFA）情况,成功率及其影响因素进行回顾性总结.结果 42只眼中,首次及再次手术后3～6周有20只眼建立脉络膜视网膜静脉吻合,成功率47.6％成功与未成功眼,术后平均最佳矫正视力差异有非常显著性意义,（P＜0.001）.成功眼术后视盘水肿、视网膜出血、黄斑水肿消失或减轻,FFA显示视网膜静脉回流障碍改善.1.0～2.5W激光能量水平成功率53.1％,且对视网膜损害较轻.平均随访11月未观察到永久性影响视力的并发症发生.结论 该手术治疗非缺血型RVO安全、有效,是一种比较有前景的方法,RVO的病程、激光能量水平及击射部位是影响疗效及视力预后的重要因素.

Objective To approach effectiveness, safety, and influencing factors of treatment of nonischemia retnal vein occlusion （RVO）with laser-induction chorioretinal vein anastomosis. Methods Retrospective data analysis（including visual acuity, fundus fluorescein angiography（FFA）, achievement ratio and influencing factor）was conducted in 42 patients （42-eyes）with nonischemia RVO with laser-induction chorioretinal vein anastomosis. Results In 3 to 6 weeks postperation, there was 20 eyes establish ment choroids-occlusion vein anastomose in patients（47. 6%）;there were significant statistic difference between achievement and failure patients in average corrected vosion. Papilloedema, retinal hemorrhage and macular edema were elimination or extenuation in succeed patients, and amelioration of retinal venous return hindrance was verificated by FFA. 1.0-2. 5W laserenergy was safety to ratinal（achievement ratio 53. 1%）. There were no complications that influence vision permanencely has been observed with 11 months followup. Conclusion laser-induction chorioretinal vein anastomosis is safety and utility to nonischemia RVO, and a perspective method, course of RVO,level of laser energy and shoting location are the important factors of curative effect and prognosis.