视网膜脱离复位术并发大量视网膜下及玻璃体积血手术治疗

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目的 :探讨巩膜外扣带术 (scleral buckling procedures,SBP)并发大量视网膜下及玻璃体积血 (subretinal and vitreoushemorrhage)手术治疗方法及疗效。方法 :回顾性分析 SBP并发视网膜下及玻璃体积血 7例患者 7只患眼 ,出血后 2~ 8周经睫状体扁平部巩膜三切口玻璃体切除 ,剥离玻璃体后皮质 ,视网膜切开及清除视网膜下积血 ,硅油或气体填充等手术治疗后 ,随访时间 4~ 12月 (平均 6个月 )的临床资料。结果 :3只患眼 (42 .9% )术后发生视网膜前纤维增殖 ,经过了二次增殖膜剥离手术治疗。最后随诊 7只患眼视网膜均得到良好复位 ;视力≥ 0 .1者 6只眼 ,占 85 .7% ,最好矫正视力为 0 .4。结论 :玻璃体视网膜手术能有效清除 SBP并发大量视网膜下及玻璃体积血 ,但血浆成份的不彻底清除而易发生视网膜纤维增殖 Objective: To investigate the surgical treatment of scleral buckling procedures (SBP) complicated with massive subretinal and vitreous hemorrhage. Methods: Seven patients with SBP complicated with subretinal and vitreous hemorrhage were retrospectively analyzed. Seven patients underwent resection of the sclera three incisions at the ciliary body after 2 to 8 weeks after hemorrhage. The vitreous posterior cortex was excised, the retina was dissected and the subretinal product was removed Blood, silicone oil or gas filled surgical treatment, follow-up time from April to December (mean 6 months) of clinical data. RESULTS: Three eyes (42.9%) had proliferative retinal fibers before and after secondary proliferative membrane dissection. The final follow-up of 7 eyes with retinal reattachment were good; visual acuity ≥0.1 in 6 eyes, accounting for 85.7%, the best corrected visual acuity was 0.4. Conclusion: Vitreoretinal surgery can effectively remove SBP complicated with massive subretinal and vitreous hemorrhage, but not completely remove the plasma components and prone to retinal fiber proliferation
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