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題 名 | Clinical Study of Giant Retinal Tear=巨大視網膜裂孔之臨床研究 |
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作 者 | 張國盛; 楊中美; 楊長豪; 黃正賢; 劉寬鎔; 陳慕師; | 書刊名 | 慈濟醫學 |
卷 期 | 10:2 1998.06[民87.06] |
頁 次 | 頁87-93 |
分類號 | 416.746 |
關鍵詞 | 巨大視網膜裂孔; 坦部玻璃體切除; 矽油; 過氟化碳液體; Giant retinal tear; Pars plana vitrectomy; Perfluorocarbon liquid; Silicone oil; |
語 文 | 英文(English) |
中文摘要 | 巨大視網膜裂孔造成的視網膜剝離治療預後一向不理想。台大醫院在1991至1995 年間治療了19個病人,共20隻眼睛的巨大視網膜裂孔。好發原因有高度近視(大於-10D,4 隻眼睛),眼內手術病史(6隻眼睛),和眼球穿刺傷(3隻眼睛)。除了3病例外,其餘病例 皆在手術後接受了3個月以上的追蹤(平均11.6個月)。手術方法經坦部玻璃體切除術為主, 其中除部份病例(5隻眼睛)併用高比重的perfluorocarbon liquid以達成術中視網膜的重貼 合外,其餘皆使用氣液交換即可。術後注入矽油或惰性氣體以為填壓。在17隻眼睛中,有 5隻眼睛需要兩次或以上的手術才成功貼回。15隻眼睛(88%)在最終回的門診檢查時仍保持 貼著狀態。視力較術前進步的有9個病例(53%),不變的有5個病例(29%),而退步的有3個 病例(18%)。僅有4個病例視力恢復到20/200以上。有4個病例因為併發症而接受額外的手 術,包括一個矽油誤入前房,一個併發性白內障,兩個黃斑部視網膜上的增生膜。 |
英文摘要 | Retinal detachment caused by giant tears carries unfavorable outcomes. Controversies exist in their treatment. To better understand the clinical presentation and surgical management of this disease, we retrospectively reviewed giant tear cases at National Taiwan University Hospital. Twenty eyes in 19 patients with giant retinal tears were treated between 1991 and 1995. High myopia and previous in traocular surgeries were the predominant predisposing factors. Seventeen patients (17 eyes) were followed for at least 3 months (mean 11.6 months). Pars plana vitrectomy was performed in 16 of the 17 eyes. Five eyes required more than one operation to achieve reattachment, including 4 with proliferative vitreoretinopathy and 1 with new breaks. Perfluorocarbon liquid was used in 5 eyes (29%) intraoperatively, and direct air-fluid exchange was used in the other 11 (71%). Silicone oil for long term tamponade was used in 8 eyes (50%). Final anatomical success was achieved in 15 eyes (88%). Visual acuity was improved in 9 eyes (53%), stationary in 5 (29%), and worse in 3 (18%). Only 4 eyes (24%) had a final visual acuity better than 20/200. After reattachment, additional procedures were done in 4 eyes: one for retained silicone oil in the anterior chanmber, one for complicated cataract and the other two for epiretinal membranes. The study indicates that most giant tears can achieve successful results anatomically with modern surgical techniques. Nontheless, the visual acuity improves in only about half of the cases. |
本系統中英文摘要資訊取自各篇刊載內容。