【摘要】 目的探讨玻璃体切割术治疗急性视网膜坏死(Acuteretinalnecrosis,ARN)的有效性及手术时机选择。方法对11例(11只眼)ARN患眼进行玻璃体切割手术,其中7只眼伴严重玻璃体混浊,2只眼伴局限性视网膜脱离,2只眼视网膜全脱离、多发性裂孔。年龄12岁～55岁,平均342岁,手术眼距初发病时间20天至8个月,其中3个月以内者9例。术前视力手动/10～30cm者2例,指数/20～30cm者2例,002～008者4例,01者3例。诊断明确后即予阿昔洛韦或更昔洛韦及皮质类固醇治疗。然后对严重玻璃体混浊,视网膜炎性渗出范围超过赤道区到达后极部,周边部已发现干性裂孔或有广泛玻璃体视网膜增殖性病变者采用玻璃体切割术,切除混浊之玻璃体,清除增殖及大部分渗出灶,作次全视网膜光凝。11例中8例辅助巩膜外环扎术,6例作晶体切除,10只眼一次性注入硅油填充,另1只眼作气液交换后12d发生视网膜、脉络膜广泛脱离,二次手术注入硅油。结果随访8个月至3年,平均193个月。11只眼中9只眼视网膜平伏,2只术前有视网膜脱离眼取硅油术后复发性视网膜脱离,无光感。成功9只眼视力均保持FC/30cm以上的有用视力,其中4只眼视力01,3只眼视力02。视力≥01者占78%。结论对ARN病情发展严重者选择适当时机,即在视网膜脱离发生前,已有严重玻璃体混浊影响眼底观察和激光治疗?更多还原

【Abstract】 Objective To probe the effectiveness and the selection of operating juncture for the treatment of acute retinal necrosis (ARN) by vitrectomy.Methods Eleven eyes were treated with vitrectomy,7 eyes were accompanied by serious vitreous turbidity,2 had local retinal detachment,2 had whole retinal detachment and retinal holes.Endophotocoagulation were carried out in all cases.Results Eight months to 3 years after the operation,9 of the 11 eyes had retinal attachment,2 eyes with retinal detachment before operation had recurrent retinal detachment after removal of silicone and had no light feeling.The 9 successful eyes had kept FC/30cm and up visual acuity,in which 4 had 0 1 visual acuity,3 had 0 2 visual acuity.Conclusions Selscting adequate juncture to carry out vitrectomy for those serious ARN cases can avoid the occur or development of retinal and keep effective visual acuity.更多还原