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目的 探讨玻璃体手术治疗伴有广泛渗出性视网膜脱离的Coats病患者的疗效 ,并观察其预后。方法 1995年 12月至 1999年 12月 ,对 11例 (11只眼 )伴有严重渗出性视网膜脱离或显著视网膜前增殖的Coats病患者进行玻璃体手术治疗。随访时间 3个月至 4 5年。 11例中除 1例为黄斑前纤维增殖牵引性视网膜脱离外 ,余均为视网膜全脱离 ;其中 4例尚伴有广泛的视网膜前增殖和牵引。结果 11例患者中除 1例终止手术外 ,余均获得有用视力 ,其中 3只眼视力优于 0 0 2 ,最佳视力0 2。 10例视网膜复位满意 ,1例终止手术失访。术后随访有 4例视网膜脱离复发 ,经治疗后视网膜均重新复位 ,玻璃体手术的成功率为 90 9%。结论 对视功能严重受损的Coats病患者 ,行玻璃体手术结合眼内光凝或巩膜外冷凝可使视网膜复位 ,促进渗出性病变退缩 ,有效保持有限的视功能 ,避免严重并发症的发生
Objective To investigate the curative effect of vitrectomy on patients with Coats disease with extensive exudative retinal detachment and observe its prognosis. METHODS: From December 1995 to December 1999, vitreous surgery was performed in 11 patients (11 eyes) with Coats disease with severe exudative retinal detachment or significant retinal pre-retinal proliferation. Follow-up time of 3 months to 45 years. Among the 11 cases, except for 1 case, the former had retinal detachment except macular degeneration and retinal detachment. In 4 cases, there were extensive pre-retinal proliferation and traction. Results Of the 11 patients, except 1 patient whose operation was terminated, all the remaining patients had useful visual acuity. The visual acuity of 3 eyes was better than 0 0 2 and the best visual acuity was 0 2. Retinal reattachment was satisfactory in 10 cases, and one patient was lost to follow-up surgery. Four cases were followed up for retinal detachment recurrence. After treatment, the retina was repositioned. The success rate of vitreous surgery was 90.9%. Conclusion In patients with Coats disease with severe visual impairment, vitrectomy combined with intraocular photocoagulation or extra-scleral condensation can restore the retina and promote the exudative lesions to retreat, effectively maintain the limited visual function and avoid the occurrence of serious complications