手术治疗蛛网膜下腔出血引起的双眼玻璃体出血

Surgical treatment of bilateral vitreous hemorrhage following subarachnoid hemorrhage

目的 评价玻璃体切割术治疗蛛网膜下腔出血引起的双眼玻璃体出血的临床效果。方法 回顾性分析 6例蛛网膜下腔出血引起的双眼玻璃体出血患者的临床资料 ,12眼均行玻璃体切割术 ,切除混浊的玻璃体 ,部分患眼伴有增生性玻璃体视网膜病变。蛛网膜下腔出血的原因为头部外伤、颅内血管瘤破裂以及慢性粒细胞性白血病 (chronicgranulocyticleukemia,CGL)等。 结果 12眼经玻璃体切割后玻璃体腔均清亮 ,术后视力明显提高 ,其中 10眼视力≥ 0 .0 6 ,6眼视力≥ 0 .4 ,1眼视力提高不明显 ,1眼由于继发青光眼而视力下降。术后达到最佳矫正视力的时间平均为 1.5个月。结论 对蛛网膜下腔出血引起的双眼玻璃体出血应及时进行详细的眼部检查 。

Objective To assess the effectiveness of surgical treatment of bilateral vitreous hemorrhage following subarachnoid hemorrhage.Methods We retrospectively reviewed the records of 12 eyes of six patients.Each eye underwent pars plana vitrectomy to delete dense vitreous hemorrhage following subarachnoid hemorrhage.Some patients complicated with proliferative vitreoretinopathy.The causes of subarachnoid hemorrhage were trauma,intracranial aneurysm rupture,and chronic granulocytic leukemia.Results Vitrectomy resulted in a permanently clear vitreous cavity in all 12 eyes.The visual acuity improved significantly,reaching 0.06 or greater in 10 of the 12 eyes,and 6 eyes gained visual acuity≥ 0.4 .One eye achieved limited improvement.Secondary glaucoma was observed in one eye,and it's visual acuity deteriorated.The time to best visual acuity is 1.5 months postoperatively.Conclusions All patients with bilateral vitreous hemorrhage following subarachnoid hemorrhage should undergo a detail eye examination in time.Surgical intervention is highly effective in hastening visual rehabilitation of these patients.