摘要
目的 观察表面麻醉下行 2 5 G经结膜无缝合玻璃体视网膜手术的疗效、适应证和并发症。 方法 回顾分析 2 2例爱尔卡因滴眼液表面麻醉下采用 2 5 G经结膜无缝合玻璃体切割手术系统 (TSV2 5 G)行玻璃体视网膜手术患者的临床及随访资料。 2 2例患者均为单眼患病接受治疗。其中特发性黄斑裂孔 10只眼 ,特发性黄斑前膜 6只眼 ,玻璃体黄斑牵引综合征 4只眼 ,视网膜分支静脉阻塞玻璃体积血 2只眼。根据病情行视网膜前膜、黄斑前膜和 (或 )内界膜剥离 ,气液交换和全氟丙烷 (C3F8)气体眼内充填。手术后随访 1～ 11个月 ,平均随访时间 6 .4个月。主要观察分析手术中的镇痛效果、患者合作程度、手术效果以及手术中和手术后并发症。 结果 所有手术眼均可在表面麻醉下顺利完成手术操作。手术时间 2 0～ 2 5 min,平均手术时间约 2 2 min。手术中患者无特别不适 ,能配合手术 ;手术后 2 d内手术创口结膜轻度水肿 ,7d后已无明显痕迹。1个月时仅在巩膜表面见一浅的色素沉着点。手术后一过性眼压升高 2只眼 ,晶状体后囊羽毛状混浊 5只眼 ,玻璃体积血 1只眼 ,结膜下气泡 2只眼。未发生感染性眼内炎、医源性视网膜裂孔及视网膜脱离、脉络膜脱离以及其他与切口相关的并发症。特发性黄斑裂孔患者 9只眼裂孔闭合 ,1只眼裂孔?
Objective To evaluate the indications, effectiveness and complications of vitreoretinal surgery using the 25G transconjunctival sutureless vitrectomy system (TSV25G) under the topical anesthesia. Methods The clinical and follow-up data of 22 eyes of 22 patients undergone vitreo-retinal surgery using TSV25G under the topical anesthesia were retrospectively analyzed. All of the patients were monocular sickened, including idiopathic macular hole in 10 eyes, idiopathic macular pucker in 6, vitreoretinal traction syndrome in 4, and vitreous hemorrhage associated with branch retinal vein occlusion in 2. Peeling of epiretinal membrane and/or internal limiting membrane, intraocular laser coagulation, air-fluid exchange and tamponiding of C 3F 8 were performed according to the condition of diseases. The postoperative follow-up was 1-11 months, with the mean duration of 6.4 months. The effect of analgesia, cooperation with the patients, operative effect and complications in and after the surgery were observed. Results The operations finished successfully in all of the eyes under the topical anesthesia. The operation duration ranged from 20 to 25 minutes with average of 22 minutes. The patients cooperated with the doctor well without any discomfort. Two days after the surgery, edema of the wounded conjunctiva was found, and recovered 7 days later. A light pigment dot on the surface of the sclera could be seen at the first month. The complications included transient increasing of intraocular pressure in 2 eyes, feather-like opacity of lens in 5 eyes, vitreous hemorrhage in 1 eye, and air-bleb under conjunctiva in 2 eyes. No other complications related with the cut were found. The macular hole closed in 9 eyes with idiopathic macular hole, and the other 1 had the smaller but not closed hole. Idiopathic macular pucker, vitreoretinal traction syndrome, and vitreous hemorrhage associated with branch retinal vein occlusion were cured successfully. Conclusions Vitreoretinal surgery using the TSV25G under the topical anesthesia has many advantages such as simple procedure, short operation time, micro-invasion, less complications and rapid revovery, and mainly serves simple manipulation in some simple diseases such as idiopathic macular hole, vitreo-retinal traction syndrome, and simple hemorrhage.
出处
《中华眼底病杂志》
CAS
CSCD
2004年第3期133-136,共4页
Chinese Journal of Ocular Fundus Diseases
