PHOTIC RETINAL INJURY FROM ENDOILLUMINATION DURING VITRECTOMY
PHOTIC RETINAL INJURY FROM ENDOILLUMINATION DURING VITRECTOMY
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DOI：
10.1016/s0002-9394(14)76894-1
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发表时间：
1991-01-15
影响因子：
4.2
通讯作者：
MASSEY, M
中科院分区：
文献类型：
--
作者：
KUHN, F;MORRIS, R;MASSEY, M
我们治疗了一名在内窥镜黄斑上膜去除后出现黄斑旁区域光诱发视网膜损伤的患者。 术后彩色照片显示膜完全缺失，但荧光素血管造影显示先前不存在的上黄斑旁病变与光损伤一致。 手术显微镜照明已被角膜屏蔽消除，这意味着内照明是损伤的根源。 我们建议采取以下程序来避免这种并发症： 仔细规划玻璃体手术以去除黄斑外膜；使用过滤器；最大限度地缩短手术时间；保持低光输出；保持光管与视网膜的最大距离；光管的偏心方向；以及使用间歇性和可变场地照明技术。
We treated a patient who developed a paramacular area of light-induced retinal damage after endoscopic epimacular membrane removal. Postoperative color photographs showed complete absence of the membrane, but fluorescein angiography demonstrated a previously absent superior paramacular lesion consistent with a photic injury. Operative microscope illumination had been eliminated by corneal shielding, which implicated endoillumination as the source of injury. We recommend the following procedures to avoid this complication: careful planning of vitreous surgery for epimacular membrane removal; using filters; minimizing the length of surgery; keeping the light output low; maintaining maximal light pipe distance from the retina; eccentric orientation of the light pipe; and use of intermittent and variable site illumination techniques.