MANAGEMENT OF ANTERIOR AND POSTERIOR PROLIFERATIVE VITREORETINOPATHY - XLV-EDWARD-JACKSON-MEMORIAL-LECTURE
MANAGEMENT OF ANTERIOR AND POSTERIOR PROLIFERATIVE VITREORETINOPATHY - XLV-EDWARD-JACKSON-MEMORIAL-LECTURE
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DOI：
10.1016/0002-9394(88)90580-6
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发表时间：
1988-11-15
影响因子：
4.2
通讯作者：
AABERG, TM
中科院分区：
文献类型：
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作者：
AABERG, TM
增殖性玻璃体视网膜病变是前部和后部增殖的复合体，产生多方向的牵引力，并由此产生复杂的处理问题。在一系列连续98例非糖尿病、非外伤性增殖性玻璃体视网膜病变的病例中，58例患者的前部增殖性视网膜病变导致视网膜脱离。玻璃体底部及其邻近表面的前部增生所产生的环向牵引力的松弛是通过玻璃体底部的多个放射状切口实现的。通过切开移位的前部和后部玻璃体表面，消除了玻璃体底部和相关的视网膜前移位。随后松解后牵引，并在最后用作用时间较长的气体或硅油充填之前，通过顺序的流体-空气交换来确定剩余牵引力。在仅有后部增生的33只眼中，23只眼(70%)实现了视网膜完全复位，而在47只眼中，有27只眼(57%)实现了明显的前部增生。33只眼中有27只眼(82%)和47只眼中37只眼(79%)在巩膜扣带后有视网膜附着。尽管前部增殖眼的成功率较低，但随着经验的增加和对临床意义认识的增加，两组的视网膜复位率接近相似。
Proliferative vitreoretinopathy is a composite of anterior and posterior proliferation producing multidirectional tractional forces and resultant complex management problems. In a series of 98 consecutive cases of nondiabetic, nontraumatic proliferative vitreoretinopathy, anterior proliferation caused retinal detachment in 58 patients. Relaxation of circumferential traction created by anterior proliferation in the vitreous base and its contiguous surfaces is achieved by multiple radial incisions in the vitreous base. Forward displacement of the vitreous base and associated anterior retina is eliminated by incision of the displaced anterior and posterior hyaloid surfaces. The subsequent release of posterior traction and determination of residual traction by sequential fluid-air exchange before final tamponade with longer acting gas or silicone oil is described. Total retinal reattachment was achieved in 23 of 33 eyes (70%) with only posterior proliferation compared to 27 of 47 eyes (57%) with significant anterior proliferation. Retinal attachment posterior to the scleral buckle was achieved in 27 of 33 eyes (82%) and 37 of 47 eyes (79%), respectively. Although the success rate was less in eyes with anterior proliferation, the retinal reattachment rates in the two groups approached comparability as experience and understanding of the clinical significance increased.