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題名 | 於複雜性視網膜剝離之玻璃體切除術合併使用鞏膜收縮術:初報 |
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作者姓名(中文) | 郭瑜良; 劉寬鎔; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷期 | 34:4 1995.12[民84.12] |
頁次 | 頁61-67 |
分類號 | 416.746 |
關鍵詞 | 複雜性視網膜剝離; 玻璃體切除術; 鞏膜收縮術; Scleral shortening; Surface coagulation; Intraocular tamponade; Relaxing retinotomy; |
語文 | 中文(Chinese) |
中文摘要 | 複雜性視網膜剝離如增殖性糖尿病視網膜病變(PDR)或增殖性玻璃體視 網膜病變(PVR)等,因有很強之牽引力量及增殖膜,常需施行玻璃體切除術才能 使網膜復位。而術中有時遇到視網膜收縮變短(retinal shortening)、裂孔的出現, 以及無法完全剝除(peeling)的增殖膜等狀況,以致即使做了氣體填塞術(air tamponade)後仍無法使網膜復位。此時合併使用鞏膜收縮術可縮減鞏膜表面積而 使網膜表面積縮減之情形緩解,並能緩除牽引及裂孔因素提高網膜復位的成功 率。我們自4年前開始試用此法,以電燒造成鞏膜表面凝縮(suiface coagulation)來 達到鞏膜表面積縮減之效果,發現簡單迅速且成效不錯,可避免傳統上施行鬆弛 性視網膜切開術(relaxing retinotomy)之諸多併發症,又無一般電燒易發生之鞏膜壞 死。今提出此法及10例報告。其中七例成功復位,視力皆能穩定或進步,追蹤期 間自6個月至3.5年,無特殊之併發症出現。 |
英文摘要 | Retinal shortening is sometimes noted during thevitrectomy for complicated retinal detachment of PDR or PVR. Because of disproportional surfacearea between retina and choroid-RPE layer, retinalshortening can't be overcome with intraoculartamponade. Methods for reducing unequal surfacearea such as scleral shortening or relaxing retinotomymust be used for further retinal reattachment. Diathermic scleral shortening is developed forthis problem. After complete membrane peeling andair-fluid exchange, retinal shortening is proved as a"tenting" retina. We use diathermic surface coagula-tion to shorten the sclera subsequently. Diathermicsurface coagulation is achieved when the energy ofwet-field bipolar -is adjusted to the point, which causes scleral shrinkage without "yellowish" colorchange. It must be applied over a well-rinsed scleralsurface without episcleral tissue. The diathermicpatches arb scattered over the area of retinalshortening without overlapping to avoid overdiathermy. Finally, intraocular tamponade is givenfor retinal reattachment. It takes only several minutesto perform this procedure. Among 10 cases received this procedure, 7 casesgot reattachment with stationary or improved visualacuity. Follow up periods range from 6 months to3.5 years. No major complications are noted. Itseems that diathermic scleral shortening is a quick,safe, easy and effective method compared withtraditional scleral shortening and relaxing retinotomy. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。