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术中光学相干断层扫描(OCT)辅助下增生性玻璃体视网膜病变的手术治疗

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对患者及其外科医生而言,增生性玻璃体视网膜病变(PVR)是近期孔源性视网膜脱离(RD)后的一大麻烦。尽管初始手术效果极佳,但PVR是导致RD复发的最常见原因,通常导致患者最终视力下降[1]。即使患者最初未发生黄斑脱离,在既往玻璃体切除术后视网膜可再次快速脱离,常累及黄斑,可能需要多次手术来保持视网膜永久附着。尽管对多种药剂进行了试验[2-5],但目前仍缺乏预防PVR的常规方法。

简介

PVR手术难度相当大,其原因复杂多样,包括对抗视网膜脱离的膜剥除反牵拉力减小、创建额外视网膜孔的风险、出血、或可引发新PVR的炎症以及极有可能需在术后保持俯卧位以保持视网膜附着。PVR可能表现为突出的白色纤维化组织,包裹近邻的视网膜组织,形成典型“折纸星星”样。PVR还可能表现为薄片样,无明显变形。PVR剥除不完整可能会妨碍视网膜附着或导致硅油填充取出后RD复发。因此,应尽可能完整剥除PVR,最大程度增加视网膜永久附着的可能性。

About Dr. Robert Sisk

Robert Sisk, MD is Associate Professor of Ophthalmology at the University of Cincinnati. He is a Vitreoretinal Surgeon and partner at Cincinnati Eye Institute and serves as Director of Pediatric Retinal Surgery and Director of Ophthalmic Genetics at Cincinnati Children’s Hospital. He completed a Vitreoretinal fellowship at Bascom Palmer Eye Institute after his Ophthalmology residency at University of Cincinnati. He is a principal investigator for numerous clinical trials with interests in gene and cell therapy, macular degeneration, and diabetic retinopathy.

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