CAJ | 학술논문

目的观察Resight非接触广角镜下行25G玻璃体切割术治疗严重Valsalva视网膜病变的效果.方法回顾性分析2011年7月至2012年12月在南昌大学附属医院眼科应用Resight非接触广角镜下,行25G玻璃体切割术治疗8例8只眼严重Valsalva视网膜病变眼的临床资料.患者中男性6例,女性2例;年龄24～48岁,平均年龄35岁;右眼5只,左眼3只;最佳矫正视力为眼前手动至眼前指数;发病时间23 ～60天,平均42天;所有患者均经病史咨询和眼底荧光血管造影、眼底照相、眼科B超等检查,确诊为严重的Valsalva视网膜病变.患眼黄斑部均大面积视网膜前出血,经ND:YAG激光治疗或药物保守治疗积血未消退,而后接受在Resight非接触广角镜下行25G玻璃体切割术.手术方式为闭合三通道玻璃体切割术,术毕玻璃体腔未注射任何药物,也未使用任何填充物.术后随访观察2～12个月,平均8个月.结果在Resight非接触广角镜下用25G玻璃体切割手术治疗严重的Valsalva视网膜病变,手术时间最短10 min,最长16 min,平均手术时间为12 min.术后视力均显著提高,末次最佳矫正视力3只眼为0.9,4只眼为1.0,1只眼为1.2;所有患者黄斑部出血完全消退,眼底荧光血管造影未发现明显异常;术后眼压均正常,术后2周内有1只眼出现轻度玻璃体混浊,1个月后消退,无视网膜脱离、并发性白内障等并发症发生.结论在Resight非接触广角镜下行25G玻璃体切割手术治疗严重的Valsalva视网膜病变,其广角系统及微创玻璃体切割系统的有机结合,能明显缩短手术时间,快速恢复视力,而且并发症少,是治疗严重Valsalva视网膜病变的安全、有效方法.
목적 관찰Resight비접촉엄각경하행25G파리체절할술치료엄중Valsalva시망막병변적효과.방법 회고성분석2011년7월지2012년12월재남창대학부속의원안과응용Resight비접촉엄각경하,행25G파리체절할술치료8례8지안엄중Valsalva시망막병변안적림상자료.환자중남성6례,녀성2례;년령24～48세,평균년령35세;우안5지,좌안3지;최가교정시력위안전수동지안전지수;발병시간23 ～60천,평균42천;소유환자균경병사자순화안저형광혈관조영、안저조상、안과B초등검사,학진위엄중적Valsalva시망막병변.환안황반부균대면적시망막전출혈,경ND:YAG격광치료혹약물보수치료적혈미소퇴,이후접수재Resight비접촉엄각경하행25G파리체절할술.수술방식위폐합삼통도파리체절할술,술필파리체강미주사임하약물,야미사용임하전충물.술후수방관찰2～12개월,평균8개월.결과 재Resight비접촉엄각경하용25G파리체절할수술치료엄중적Valsalva시망막병변,수술시간최단10 min,최장16 min,평균수술시간위12 min.술후시력균현저제고,말차최가교정시력3지안위0.9,4지안위1.0,1지안위1.2;소유환자황반부출혈완전소퇴,안저형광혈관조영미발현명현이상;술후안압균정상,술후2주내유1지안출현경도파리체혼탁,1개월후소퇴,무시망막탈리、병발성백내장등병발증발생.결론 재Resight비접촉엄각경하행25G파리체절할수술치료엄중적Valsalva시망막병변,기엄각계통급미창파리체절할계통적유궤결합,능명현축단수술시간,쾌속회복시력,이차병발증소,시치료엄중Valsalva시망막병변적안전、유효방법.
Objective To observe the effect of 25G vitrectomy for the serious Valsalva retinal disease with the help of Resight non-contact wide angle lenses.Methods Retrospectively analyzed the clinical data of 8 cases (8 eyes) with the serious Valsalva retinal disease using 25G vitrectomy with the help of Resight non-contact wide angle lenses.The 8 patients included 6 male and 2 female,with the age of 24-48 years old (meanly 35 years).In these 8 eyes,the right eyes were in 5,and the left in 3.The BCVA was hand movement to finger counting.The onset time was 23-60days,meanly 42 days.The diagnosis of the serious Valsalva retinal disease was made by history consulting,fundus fluorescence angiography,fundus photography,ophthalmic B-ultrasound and so on.The epiretianl hemmorrhage was found in macular area of all eyes.The hemorrhage did not regress with the treatment of NAG or drug.Then,these patients underwent 25G vitrectomy with the help of Resight non-contact wide angle lenses.The entrance of vitrectomy was closed triple incisions.The vitreous cavity was not injected with any drug,not temponaded with any material.Follow-up time was for 2-12 months,meanly 8 months.Results The serious Valsalva retinal disease was underwent vitrectomy using 25G with the help of Resight non-contact wide angle lenses.The operation time was 10-16 minutes,meanly 12 minutes.The postoperative BCVA increased markedly.The last BCVA was 0.9 in 3 eyes,1.0 in 4 eyes,1.2 in leye.The intraocular pressure was normal postoperatively.The light vitreous opacity occurred in 1 eye after 1 week,and regressed after 1 month.Retinal detachment and complicated cataract did not occur in no one eye.Conclusions Vitrectomy for the Valsalva retinal disease with the help of Resight non-contact wide angle lenses can increase visual acuity,shorten operation time,decrease complication because of the combination with the wide angle system and minimal invasion vitrectomy system.It is effective and safe for the treatment of serious Valsalva retinal disease.