玻璃體手術後患者再施行眼內液體氣體互換手術之探討

Experience in Intravitreal Fluid-Gas Exchange Following Vitrectomy

林嘉理(Chia-Lee Lin) ； 劉榮宏(Jorn-Hon Liu) ； 黃書紳(Shu-Shen Huang)

《中華民國眼科醫學會會刊》 25卷1期 (1986/05) Pp. 283-290

https://doi.org/10.30048/ACTASOS.198605.0051

摘要

玻璃體腔內液體氣體互換手術，可用來治療玻璃體手術後之玻璃體再出血或視網膜再剝離。本文自民國73年6月至74年6月，對65位患者，66眼，施行上述手術。結果玻璃體再出血組之成功率為55.5%。視網膜再剝離組為50%。且視力均有進步。然而手術併發症計有，針尖傷及水晶體7例，視網膜新生裂孔4例，青光眼11例，氣體由裂孔進入視網膜下2例。本文詳述適應症，操作方法及所須選擇的氣體。作者並改良傳統病人俯臥的操作方法為向患眼方向側臥，使手術進行更順利。在病患將要接受第二次雜複的視網膜或玻璃體手術前，此種液體氣體互換手術，實在是值得嘗試的一種治療方法。

並列摘要

A simple modified technique of intravitreal fluid-gas exchange is introduced for cases of recurrent vitreous hemorrhage, unsetted retinal detachment following vitrectomy or scleral buckling procedures. The mechanism creats an internal gas temponade effect to cease the vitreous hemorrhage or replaced retinal detachment. 65 patients, 66 eyes received the exchange during 1 year period between June 1984 to 1985. There were divided into two groups, (A) a recurrent vitreous hemorrhage group, which included, Branch retinal vein occlusion, 3 cases; Proliferative diabetic retinopathy, 11 cases; Combined with retinal detachment, 2 cases; (B) recurrent retinal detachment group, which are retinal detachment without PVR, 17 cases; retinal detachment with PVR, 15 cases; giant retinal break, 3 cases; tractional retinal detachment, 6 cases; and macular hole, 9 cases.
The successful rate for group A was 55.5% and group B was 50%. The visual outcome reveals improved in 62.5% of group A and 36% of group B. The complications were (1) needle damage to the lens, 7 cases; (2) a new retinal break, 4 cases; (3) temporary intraocular pressure elevation, 11 cases; (4) the present of gas in subretinal space, 2 cases.
This procedure is worth recommending because good results can be achived before the patient goes to a secondary complicated sugery.

並列關鍵字

intraocular fluid-gas exchange ； recurrent vitreous hemorrhage ； recurrent retinal detachment ； sulfar hexafluoride