"En bloc" excision of diabetic membranes.
"En bloc" excision of diabetic membranes.
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“整体”切除糖尿病膜。
DOI：
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发表时间：
1987
期刊：
影响因子：
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通讯作者：
George A. Williams
中科院分区：
文献类型：
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作者：
Gary W. Abrams;George A. Williams
我们采用一种新的手术解剖方法治疗了16只眼糖尿病牵引性视网膜脱离，将糖尿病视网膜前膜和粘连的后玻璃体作为一个整体切除。该方法不同于先前报道的糖尿病膜剥离方法，其利用后玻璃体在用水平切割剪切除膜时提起和覆盖膜。后玻璃体的保留有利于膜与视网膜的分离。纤维血管增生被更完全地去除，出血比膜切片技术少。主要的手术并发症是后视网膜裂孔（7只眼），但随着牵引力的接近完全缓解，所有的裂孔都成功地用气体填充和激光光凝治疗。13例视网膜完全复位，至少随访4个月。一只眼睛发生黄斑外牵引性视网膜脱离，两只眼睛发生周边（晶状体后）纤维血管增生。11只眼的视力为5/200或更好。
We treated 16 eyes with diabetic tractional retinal detachment with a new method of surgical dissection whereby diabetic preretinal membranes and adherent posterior hyaloid were excised and removed as a single unit. This method differs from previously reported methods of diabetic membrane dissection by utilizing the posterior hyaloid to lift and immobilize the membrane as the membrane is excised with horizontally cutting scissors. The preservation of the posterior hyaloid facilitates the separation of the membrane from the retina. Fibrovascular proliferation was more completely removed and bleeding was less than with membrane sectioning techniques. The major surgical complication was posterior retinal break (seven eyes), but with near complete relief of traction all breaks were successfully treated with gas tamponade and laser photocoagulation. Thirteen retinas were completely reattached with a minimum follow-up of four months. One eye developed an extramacular tractional retinal detachment, and two eyes developed peripheral (retrolenticular) fibrovascular proliferation. Eleven eyes had 5/200 or better visual acuity.