本文選題：玻璃體內注射　切入點：曲安奈德　出處：《眼科新進展》2017年08期

【摘要】：目的觀察內界膜剝除聯合玻璃體內注射曲安奈德治療繼發(fā)性黃斑前膜的療效。方法回顧性分析我院2011年6月至2015年6月因繼發(fā)性黃斑前膜需行玻璃體視網膜手術者42例42眼,所有患者均行標準的23 G經睫狀體平坦部的三通道玻璃體切割+黃斑前膜剝除+視網膜內界膜剝除+玻璃體內注射曲安奈德術,術后隨訪3.0~18.0(8.3±2.4)個月,對手術前后最佳矯正視力、黃斑形態(tài)及手術并發(fā)癥等進行觀察。結果隨訪期末,最佳矯正視力提高者30眼,不變者8眼,下降者4眼;術后最佳矯正視力與術前相比,差異有統(tǒng)計學意義(t=3.145,P=0.000)。黃斑中心神經上皮層厚度術前為(315.62±132.12)μm,術后為(233.42±146.32)μm,手術前后相比差異有統(tǒng)計學意義(t=4.322,P=0.000)。術后視網膜少許出血6眼,玻璃體積血1眼,一過性高眼壓6眼;3眼周邊牽引性小裂孔,激光治療后,行玻璃體內C_3F_8填充,視網膜在位。結論玻璃體內注射曲安奈德可以加速黃斑水腫消退,降低黃斑前膜復發(fā),促進視功能恢復。視網膜內界膜剝除在繼發(fā)性黃斑前膜手術中可以松解黃斑區(qū)視網膜皺褶,解除對黃斑中心凹的牽引,改善黃斑區(qū)局部的代謝,有利于黃斑功能的恢復。
[Abstract]:Objective to observe the efficacy of intravitreal injection of triamcinolone acetonide in the treatment of secondary macular membrane. Methods 42 cases (42 eyes) of secondary macular membrane underwent vitreoretinal surgery in our hospital from June 2011 to June 2015. All patients were treated with standard 23 G triamcinolone acetonide injection through the 3 channels vitrectomy of the flat part of the ciliary body. The best corrected visual acuity was obtained before and after the operation, and the intravitreal injection of triamcinolone acetonide was performed. The postoperative follow-up was 3. 0 鹵18. 0 鹵2. 4 鹵2. 4 months. Results at the end of follow-up, the best corrected visual acuity was improved in 30 eyes, unchanged in 8 eyes and decreased in 4 eyes. The thickness of neuroepithelial layer in central macular area was 315.62 鹵132.12 渭 m before operation and 233.42 鹵146.32 渭 m after operation. The difference was statistically significant before and after operation. There was little retinal hemorrhage in 6 eyes and vitreous hemorrhage in 1 eye. The intravitreal injection of triamcinolone acetonide could accelerate the regression of macular edema and reduce the recurrence of macular membrane after laser treatment with intravitreal injection of triamcinolone acetonide. To promote the recovery of visual function. In the secondary macular anterior membrane surgery, the retinal fold in the macular area can be loosened, the traction on the fovea of the macular center can be relieved, the local metabolism of the macular area can be improved, and the recovery of the macular function can be facilitated.
【作者單位】： 保定市第一中心醫(yī)院眼科;
【分類號】：R779.6

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