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目的:观察玻璃体切除联合眼内激光光凝治疗玻璃体积血的临床疗效及引起玻璃体积血的原发视网膜疾病,探讨玻璃体积血病程对治疗结果的影响。方法:玻璃体积血为首诊的76例86眼,行经睫状体扁平部三通道玻璃体切除术,切除玻璃体积血及变性的玻璃体,术中行眼内视网膜激光光凝术,术后1个月行荧光素眼底血管造影检查,明确原发视网膜疾病。结果:平均随访12个月,视力提高:眼前指数-0.056眼,0.05～0.123眼,0.1～0.339眼,0.3～0.58眼,0.5以上6眼,4眼视力无变化。结论:玻璃体切除是治疗长期大量玻璃体积血的首选方法。玻璃体积血时间短,无增殖性改变,手术难度小,术后视力好。玻璃体积血病程长,视网膜增殖严重,手术难度大,术中需行眼内填充,术后视力差。
OBJECTIVE: To observe the clinical efficacy of vitrectomy combined with intraocular laser photocoagulation in the treatment of vitreous hemorrhage and the primary retinal diseases that cause vitreous hemorrhage, and to explore the influence of vitreous hemorrhage duration on the outcome of the treatment. Methods: 76 cases (86 eyes) with vitreous hemorrhage were treated by three-channel vitrectomy through the pars plana. Vitreous hemorrhage and degeneration of the vitreous were removed. Intra-retinal laser photocoagulation was performed during the first month after surgery Fundus fluorescein angiography, clear primary retinal disease. Results: With an average follow-up of 12 months, the visual acuity was improved: the anterior index -0.056, 0.05-0.123, 0.1-0.393, 0.3-0.58, 0.5 or more 6 eyes, no change in visual acuity in 4 eyes. Conclusions: Vitrectomy is the preferred method of treatment for long-term large volumes of vitreous hemorrhage. Vitreous hemorrhage time is short, no proliferative changes, surgery is difficult, good visual acuity. Long course of vitreous hemorrhage, severe retinal proliferation, surgical difficulty, intraoperative need for intraoperative filling, poor visual acuity.