摘要
目的探讨小剂量（0．1ml：1mg）曲安奈德应用在复杂玻璃体视网膜手术中的疗效及并发症。方法选择复杂性玻璃体视网膜手术73例（73只眼）为实验组，选择复杂性玻璃体视网膜手术71例（71只眼）为对照组。两组患者行常规标准经平坦部三切口闭合式玻璃体切除术，完成玻璃体视网膜手术后，如为联合晶状体摘除酞，了后囊膜切开，虹膜下方行周切孔（Ando孔），然后玻璃体腔内注入硅油。实验组加用曲安奈德0．1ml：1mg玻璃体腔注射。结果（1）两组患者术后视网膜未复位率实验组为4．5％，对照组为15．2％，差异有统计学意义（P〈0．05）。硅油取出术时需再次行视网膜前部分增值膜剥除，实验组为7．6％，对照组为19．7％，实验组明显低于对照组（P〈0．05）。（2）术后视力提高、不变、下降，实验组为80．6％、15．3％、4．2％；对照组为67．6％、27．3％、5．6％。术后视力提高，实验组明显比对照组好（P〈0．05）。（3）实验组术后炎症反应较对照组轻，1例因体位关系曲安奈德颗粒进入前房，所有病例其视网膜表面颗粒1～3月均消失。（4）两组均有少数病例出现术后短期眼压增高，经应用降眼压药物处理后1周内降至正常，所有患者在整个随访过程中未有一例出现激素性青光眼。术后1d、术后1周、术后1月、术后3月、硅油取出前、最后一次随访时，两组眼压比较均差异无统计学意义（P〈0．05）。结论将小剂量（0．1ml：1mg）曲安奈德应用在复杂玻璃体视网膜手术中，明显提高了手术成功率和效果，并未有严重高眼压、激素性青光眼等并发症发生。但更长期的效果有待进一步观察和总结。
Objective To investigate the efficiency and complications of applying low-dose （0.1ml： 1mg） Triamcinolone acetonide in the complex vitreoretinal surgery. Methods Choose 73 cases （73 eyes） of complex vitreoretinal surgery as experimental group and 71 cases （71 eyes） as control group. Two groups of patients underwent the conventional standard 3-incision closed vitrectomy. After the vitreoretinal surgery, if they were combined lens extirpated eyes, performed the posterior capsulotomy and in inferior part of iris, and then inject silicon oil to intravitreal. The experimental group gave Intravitreal injection of Triamcinolone acetonide by proportion of 0.1ml：1mg. Results （ 1 ）The reset rate of Retina of the experimental group was 4.5%, and the controls group was 15.2%. The differences in reset rate of Retina between the two groups were statistically significant （P 〈0.05）. The 7.6% of experimental group before taking out Silicon oil peeling the retina membrane needed, and the controls group were 19.7%, they were statistically significant （P 〈0.05）. （2）Postoperative visu- al acuity was improved 80.6%, unchanged 15.3%, and decreased 4.2% in experimental group, and 67.6%, 27.3% and 5.6% in the controls group. In the experimental group, the advance of Postoperative visual acuity was better than the controls group （P 〈0.05）. （3） In the experimental group the Inflammation was smaller than the controls group.（4 ） Some eyes had high IOP temporarily in the two groups, but IOP could be controlled with topical medicines in all patients, while one day, one week, one month, three months and before taking out Silicon oil after treatment, the average lOP had no statistical significances in two groups （P 〉0.05）. Conclusions Applying low-dose （0. 1ml：1mg） Triamcinolone acetonide in the complex vitreoretinal surgery can rise the Success rate and efficiency. And have no complications such as high intraocular pressure, steroid glaucoma. However, long-term effect remains to be further observed and summed up.
出处
《中国实用眼科杂志》
CSCD
北大核心
2010年第9期1022-1025,共4页
Chinese Journal of Practical Ophthalmology
关键词
复杂玻璃体手术
曲安奈德
小剂量
Complex vitreorefinal surgery
Triamcinolone acetonide
Low-dose
