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目的研究曲安奈德(TA)辅助玻璃体切割手术在临床的应用价值。方法28例(29只眼)于2004年1月~2004年12月行玻璃体切割术,术中注入已过滤的TA悬浮液0.1ml(40mg/ml),以帮助辨认玻璃体后皮质、视网膜前增殖膜、黄斑前膜、内界膜,9例硅油填充,7例C3F8(15%)填充。手术后17例随访6个月以上,11例随访3至4个月。结果所有的病例,经TA注入后,可明显的改善玻璃体后皮质、视网膜前膜、内界膜的辨认情况。糖尿病视网膜病变术后视力提高占61.5%,伴PVR的视网膜脱离术后视力提高占61.3%,黄斑裂孔4例中3例术后视力提高,4例黄斑前膜术后视力均有提高。所有28例均没有出现高眼压。8例伴PVR的视网膜脱离中6例(占75%)视网膜复位,4例黄斑裂孔均关闭,2例糖尿病黄斑水肿手术后明显减轻。结论经过滤的TA可作为玻璃体切割手术中较好的辅助工具,TA悬浮液是呈白色胶样,可粘附于玻璃体皮质、视网膜前膜或内界膜,帮助分辨玻璃体后皮质、视网膜前膜、内界膜,提高手术效率。没有发现与TA有关的副作用。
Objective To investigate the clinical value of triamcinolone acetonide (TA) assisted vitrectomy in clinical practice. Methods Twenty-eight patients (29 eyes) underwent vitrectomy from January 2004 to December 2004 with 0.1 ml of filtered TA suspension (40 mg / ml) injected during operation to help identify the posterior vitreous and retinal proliferation Membrane, premacular membrane, internal limiting membrane, 9 silicone oil filled, 7 cases of C3F8 (15%) filled. Seventeen cases were followed up for more than 6 months and 11 cases were followed up for 3 to 4 months. Results All cases, after TA injection, can significantly improve the vitreous posterior cortex, the pre-retinal membrane, the identification of the internal limiting membrane. Diabetic retinopathy postoperative visual acuity increased 61.5%, retinal detachment with PVR postoperative visual acuity increased 61.3%, 4 cases of macular hole in 3 cases postoperative visual acuity improved, 4 cases of macular anterior membrane postoperative visual acuity increased. No ocular hypertension occurred in all 28 cases. Retinal detachment in 8 cases (75%) with retinal detachment retinal detachment, 4 cases of macular hole were closed, 2 cases of diabetic macular edema was significantly reduced after surgery. Conclusion The filtered TA can be used as a good auxiliary tool in vitrectomy. The TA suspension is a white colloid that adheres to the vitreous cortex, the anterior retinal membrane or the endometrial membrane, helping to distinguish between the posterior vitreous cortex, the pre-retinal membrane , The inner membrane, improve surgical efficiency. No side effects associated with TA were found.