CAJ | 학술논문

目的探讨全氟萘烷(Perfluorodecalin,PFDL)在睫状体扁平部玻璃体切除术(ParsPlana Vitrectormv,PPV)中的独特作用及在眼内长期残留时对眼组织的影响.方法回顾分析在PPV中应用PFDL的临床病例239例239只眼,其中裂孔源性视网膜脱离(retinaldetachment,RD)130例,晶状体脱位于玻璃体腔4例,外伤性RD41例,增殖性糖尿病性视网膜病变导致玻璃体出血合并牵拉性RD21例,视网膜静脉栓塞和视网膜静脉周嗣炎导致玻璃体腔出血合并牵拉性RD27例,陈旧性脉络膜出血1例,急性视网膜坏死合并视网膜脱离2例,眼内炎3例,Coats病合并牵拉裂孔性RD1例,眼内填充硅油合并RD9例.采用PPV,膜剥离,PFDL使用,眼内激光,气液交换,惰性气体及硅油眼内填充.探讨防止PFDL眼内残留的方法 ,对黄斑裂孔或后极部裂孔采用"气液交换后置换PFDL法",对巨大裂孔性视网膜脱离采用"PFDL联合部份气液交换法",对360°视网膜切开采用"逐步使用PFDL法".结果随访12～15个月,212例212只眼获得随访,视网膜复位181例181只眼,有效率85.37%,术后PFDL残留22只眼,随访期间,角膜、前房及视网膜均未见功能及结构上的改变.结论 PFDL可有效地应用于PPV中,提高治疗巨大裂孔性视网膜脱离、外伤性视网膜脱离、眼内填充硅油合并RD等复杂性视网膜脱离的手术成功率,PFDL小滴在眼内长期存留,临床上未观察到明显眼部损害.
목적 탐토전불내완(Perfluorodecalin,PFDL)재첩상체편평부파리체절제술(ParsPlana Vitrectormv,PPV)중적독특작용급재안내장기잔류시대안조직적영향.방법 회고분석재PPV중응용PFDL적림상병례239례239지안,기중렬공원성시망막탈리(retinaldetachment,RD)130례,정상체탈위우파리체강4례,외상성RD41례,증식성당뇨병성시망막병변도치파리체출혈합병견랍성RD21례,시망막정맥전새화시망막정맥주사염도치파리체강출혈합병견랍성RD27례,진구성맥락막출혈1례,급성시망막배사합병시망막탈리2례,안내염3례,Coats병합병견랍렬공성RD1례,안내전충규유합병RD9례.채용PPV,막박리,PFDL사용,안내격광,기액교환,타성기체급규유안내전충.탐토방지PFDL안내잔류적방법 ,대황반렬공혹후겁부렬공채용"기액교환후치환PFDL법",대거대렬공성시망막탈리채용"PFDL연합부빈기액교환법",대360°시망막절개채용"축보사용PFDL법".결과 수방12～15개월,212례212지안획득수방,시망막복위181례181지안,유효솔85.37%,술후PFDL잔류22지안,수방기간,각막、전방급시망막균미견공능급결구상적개변.결론 PFDL가유효지응용우PPV중,제고치료거대렬공성시망막탈리、외상성시망막탈리、안내전충규유합병RD등복잡성시망막탈리적수술성공솔,PFDL소적재안내장기존류,림상상미관찰도명현안부손해.
Objective To investigate the role ofperfluorodecalin (PFDL)in Pars Plana Vitrectormy(PPV),and influence of remnent of PFDL.Method 239 eyes were reviewed,who had undergone PPV, andPFDL was used in PPV,among them 130 eyes were complicated retinal detachment (RD),4 eyes weredislocated lens in vitreous,41 eyes were traumatic retinal detachment,21 eyes were proliferative diabeticretinopathy,27 eyes were retina vaseular disease uniting tractional retinal detachment, 1 eye was old choroidhemorrhage,2 eyes were acute retinal necrosis syndrome uniting retinal detachment,3 eyes wereendophthalmia, 1 eye was Coats disease,9 eyes were RD uniting silicone oil tamponades.PPV involving thepeeling of pre-retinal membrane,PFDL injection,endolaser, fluid～air exchange,and inert gas or silicone oiltamponades.Probed the way of avoiding remnent of PFDL in PPV, "permutation of PFDL after air-fluidexchange " was used in PPV of macular hole or posterior pole hole, "part air-fluid exchange associate with theuse of PFDL"was used in PPV of grand retina tear," PFDL was used step by step "in PPV of 360o retinotomy,Results 212 eyes were followed for 12～15mons,retinal attachment was achieved in 181 eyes,the efficiencywas 85.37%, Remnent of PFDL were found in 22 eyes, no functional and morphological changes of cornea 、anterior chamber and retina were found in follw-up period.Conelution PFDL can be safely and effectivelyused in PPV,grant retinal tear RD,RD caused by trauma ,and RD uniting silicone oil tamponades can besuccessfully treated by using PFDL,remnent of PFDL in the anterior chamber and vitreous cavity are welltolerated and do not induce ocular damage.