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目的探讨在曲安奈德(triamcinoloneacetonide,TA)辅助的PPV手术中行人工玻璃体后脱离后,玻璃体皮质的残留情况。方法90例患者行TA辅助的经睫状体平坦部玻璃体切割术,其中增殖性糖尿病视网膜病变34例(34只眼)、糖尿病性黄斑水肿16例(16只眼)、特发性黄斑裂孔17例(17只眼)、孔源性视网膜脱离23例(23只眼)。在常规的人工玻璃体后脱离后,在TA辅助下残留的玻璃体皮质被分为三种类型:弥散型、局限型和无残留。结果79.4%的增殖性糖尿病视网膜病变患者残留玻璃体皮质为弥散型,11.8%为局限型,8.8%为无残留;56.3%糖尿病性黄斑水肿患者为弥散型,25.0%为局限型,18.7%为无残留;特发性黄斑裂孔患者29.4%为弥散型,17.6%为局限型,53.0%为无残留;39.1%孔源性视网膜脱离患者为弥散型,17.4%为局限型,43.5%为无残留。结论常规的人工玻璃体后脱离后玻璃体皮质残留仍然存在,糖尿病患眼容易表现为弥散型。
Objective To investigate the residual vitreous cortex after artificial vitreous detachment in triamcinolone acetonide (TA) -assisted PPV surgery. Methods Totally 90 patients underwent pars plana vitrectomy with 34 cases (34 eyes) of proliferative diabetic retinopathy, 16 cases of diabetic macular edema (16 eyes), idiopathic macular hole 17 Cases (17 eyes), rhegmatogenous retinal detachment in 23 cases (23 eyes). After conventional posterior vitreous detachment, residual vitreous cortex with TA assist is divided into three types: diffuse, localized, and no residual. Results Residual vitreous cortex was diffuse in 79.4% of patients with proliferative diabetic retinopathy, with 11.8% being localized and 8.8% being non-residual; 56.3% of patients with diabetic macular edema were diffuse, 25.0% were localized, and 18.7% Residual; Idiopathic macular hole 29.4% were diffuse, 17.6% were localized, 53.0% no residue; 39.1% of rhegmatogenous retinal detachment patients were diffuse, 17.4% was localized, 43.5% no residue. Conclusion The residual vitreous cortex still exists after the conventional artificial posterior vitreous detachment, and the diabetic eye easily appears as diffuse.