玻璃体手术治疗视网膜静脉周围炎并发症的疗效

Vitrectomy for Eales′disease with vitreous hemorrhage

目的 观察视网膜静脉周围炎合并玻璃体积血和 (或 )牵引性视网膜脱离行玻璃体切割术的疗效及并发症。 方法 回顾性分析 1989～ 2 0 0 1年行玻璃体切割术治疗合并玻璃体积血和 (或 )牵引性视网膜脱离的视网膜静脉周围炎患者 6 9例的临床和随访资料。随访时间为手术后 6个月～ 12年 ,平均随访时间 4 5个月。 结果 (1)手术后视力较手术前显著提高。 (2 ) 11只眼有手术中并发症 ,占 14 .3% ,其中医源性裂孔 7只眼 ,手术中出血 3只眼 ,晶状体损伤 1只眼。 (3)手术后 1个月内 2 0只眼有并发症 ,占2 6 .0 % ,其中玻璃体再积血 14只眼 ,一过性高眼压 6只眼 ,视网膜脱离 5只眼 ,前房出血 2只眼 ,前房机化膜形成 1只眼。 (4)远期并发症主要为白内障 (9只眼 )及黄斑病变 (6只眼 )。 结论 玻璃体切割术联合眼内激光光凝、剥膜等是治疗视网膜静脉周围炎合并玻璃体积血和 (或 )牵引性视网膜脱离的有效手段。

Objective To investigate the effects and complications of the vitrectomy for Eales′ disease with vitreous hemorrhage or traction retinal detachment. Methods Seventy seven eyes of 69 cases undergoing vitrectomy for Eales′ disease with vitreous hemorrhage or traction retinal detachment were analyzed retrospectively. Results (1) The postoperative visual acuity was enhanced significantly. (2) Complications during the operation in 11 eyes (14.3%): iatrogenic retinal break in 7 eyes, bleeding in 3 eyes and lens damage in 1 eye. (3) Postoperative complications in 20 eyes (26.0%): rebleeding in 14 eyes, elevated IOP in 6 eyes, retinal detachment in 5 eyes, hyphema in 2 eyes, and exudative membrane in anterior chamber in 1 eye. (4) The main long term complication was cataract formation (9 eyes) and macular disorder (6 eyes). Conclusion Vitrectomy is an effective method to treat Eales′ disease with vitreous hemorrhage or traction retinal detachment.