以經平坦部切除玻璃體治療網膜血管疾病致牽扯性黃斑水腫

Pars Plana Vitrectomy for Traction Macular Edema in Retinal Vascular Disease

許淑娟(Shwu-Jiuan Sheu) ； 潘志勤(Chih-Chin Pan) ； 吳宗典(Tzong-Dean Wu) ； 莊秋同(Chiu-Tung Chuang)

《中華民國眼科醫學會雜誌》 34卷1期 (1995/03) Pp. 39-46

https://doi.org/10.30048/ACTASOS.199503.0007

摘要

我們報告六個以經平坦部玻璃體切除及後玻璃體膜分離治療牽扯性黃斑水腫的病例。五例源於糖尿病網膜症，一例源於網膜側枝靜脈阻塞。六例皆接受過黃斑雷射治療無效，後極玻璃體呈增厚拉緊狀，術前螢光血管攝影顯示深層螢光滲漏於黃斑部。手術中發現所有病例之後玻璃膜均緊著於網膜上，經仔細剝離後清除。術後，黃斑水腫均改善且視力進步。追蹤期間除第六病例發生白內障外，餘無任何術中與術後併發症。我們建議對網膜血管疾病引起之黃斑水腫，若雷射治療無效且後極玻璃體有特殊牽址性變化者，可嘗試以玻璃體手術治療。

並列摘要

Pars plana vitrectomy with separation of the posterior hyaloid was performed in six eyes with tractional macular edema with a thickened and taut premacular posterior hyaloid. All eyes have pervious macular photocoagulation for macular edema caused by diabetic retinopathy (five eyes) and branch retinal vein occlusion (1 eye) respectively. Preoperative fluorescein angiography showed a deep and diffuse pattern of leakage in the macula. Intraopaeratively, the attached and thickened posterior hyaloid was lifted and separated from the macula. Postoperatively, the macular edema decreased and vision improved in all eyes No complication developed during the follow-up period except nucleosclerosis developed in the sixth case at eighth month post operation. Vitreous surgery can improve the visual prognosis of some eyes with macular edema associated with retinal vascular disease.

並列關鍵字

Vitrectomy ； Macular edema ； Diabetic retinopathy ； Branch retinal vein occlusion