Survey of Indications and Results of Vitreoretinal Surgery in a Regional Hospital

一區域醫院視網膜手術之適應症與結果之臨床分析

楊昌叔(Chang-Sue Yang) ； 蔡景耀(Ching-Yao Tsai) ； 張庭嘉(Ting-Jia Chang) ； 翁林仲(Lin-Chung Woung)

《中華民國眼科醫學會雜誌》 42卷4期 (2003/12) Pp. 391-396

https://doi.org/10.30048/ACTASOS.200312.0001

摘要

目的：我們研究分析在臺北市一區域醫院眼科施行視網膜手術之適應症、結果及其併發症。
方法：藉回溯性分析病患病歷，自2001年10月至2002年11月之間，收集在臺北市立中興醫院眼科接受視網膜手術的病患。我們研究分析其施行視網膜手術之適應症、結果及併發症。
結果：共收集83例病患（87眼），其中男性52例，女性31例，年齡自2歲至82歲（平均53.7歲）。術後追蹤時間從六個月至十九個月，平均十二點四個月。
手術適應症包括，玻璃體出血(46.0%)、裂孔性視網膜剝離(26.4%)、牽引性視網膜剝離(5.7%)、殘留玻璃體內晶體碎片(4.6%)、黃斑部出血(4.6%)等。
視網膜剝離第一次手術後，視網膜成功回貼率78.3%(18/23)，第二次手術成功率100%(23/23)。玻璃體出血的病因包括，糖尿病視網膜病變32眼(82.5%)、視網膜靜脈阻塞(10.0%)，老年性黃斑部退化(2.5%)。視網膜手術後視力進步或穩定者有67眼(77%)，退步20眼(23%)。手術併發症包括，眼內壓增加(33.3%)、漸進性水晶體混濁(20.3%)、殘餘或再發性玻璃體出血(4.6%)、視網膜裂孔(5.7%)，及新生血管性青光眼、眼內炎各一例。
結論：本篇研究顯示在區域醫院可成功施行視網膜手術。大部分病患在視網膜手術後視力進步或穩定。

並列摘要

Purpose: To survey the indications and results of vitreoretinal surgery in a regional hospital, Taipei Municipal Chung-Hsin Hospital.
Methods: We retrospectively reviewed the medical records of patients who underwent vitreoretinal surgery in Taipei Municipal Chung-Hsin Hospital from Oct. 2001 to Nov. 2002. The indication, result and complicaition of vitreoretinal surgery were analysed.
Results: There were total 87 eyes of 83 patients enrolled in this study. The mean follow up period was 12.4 months (range 6 to 19 months). The indications of vitreoretinal surgery included non-clearing vitreous hemorrhage (46.0%), rhegmatogenous retinal detachment (26.4%), tractional retinal detachment (5.7%), retained lens fragment after phacoemulsification cataract operation (4.6%), submacular hemorrhage (4.6%), idiopathic macular hole (1.1%). The post-operative visual acuity was improved or stationary in 67 eyes (77%), worse in 20 eyes (23%). The reattachment rate after the first retinal detachment surgery was 78.3% (18/23), the final attachment rate was 100% after second operation. The causes of non-clearing vitreous hemorrhage were proliferative diabetic retinopathy in 32 eyes (82.5%), retinal vein occlusion (10.0%), age-related macular degeneration (2.5%). The operative complications included transient elevation of intraocular pressure (IOP) in 29 eyes (33.3%), cataract in 20 eyes (20.3%), recurrent vitreous hemorrhage in 4 eyes (4.6%), iatrogenic retinal break in 5 eyes (5.7%), neovascular glaucoma and post-operative endophthalmitis in one eye each.
Coclusions: Vitreoretinal surgery is technically feasible in a regional hospital of Taipei city. Most patients of retinal diseases achieved improved or stationary vision after surgery in the current study.

並列關鍵字

Pars plana vitrectomy ； retinal detachment ； vitreoretinal surgery ； vitreous hemorrhage