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[摘要] 目的 探讨视乳头切开术治疗缺血性视网膜中央静脉阻塞的临床疗效。 方法 缺血性视网膜中央静脉阻塞患者10例。术前患者均行眼底照相、荧光素眼底血管造影（FFA）检查。手术常规做玻璃体切割，应用显微玻璃体视网膜切开刀，以鼻侧视乳头边缘为中心，垂直刺入达最宽处为止。术后1，3，6个月分别行眼底照像、FFA检查。结果 术中，视乳头切开后均可见视盘近端视网膜静脉充盈增加，7例术中穿刺时有少量出血，未经特殊处理均很快停止。术后1个月内，9例患者视网膜或黄斑水肿均减轻或消退。术后3个月，患者行眼底照像、FFA检查结果均显示视网膜出血吸收，黄斑水肿消退；8例视力较术前提高（80%）。1例保持不变，1例下降，术后4周发生玻璃体出血。结论 视乳头切开术是安全有效的手术，有助于视网膜内出血、渗出及黄斑水肿的消退，部分患者视力可得到改善。 Report of radial optic neurotomy for 10 case of central retinal vein occlusion [Abstract] Objective to investigate the surgical effect of radial optic neurotomy for ischemic central retinal vein occlusion (CRVO) . Methods Ten consecutive patients (10eyes) , Preoperative examination including color fundus photography, fundus fluorescein angiography. underwent parplana itrectomy, A microvitreoretinal(MVR) blade was used to relax the scleral ring and adjacent sclera of nasal aside of the optic disk, The depth of the incision into the optic nerve placed the MVR blade just beyond the widest portion of the diamond-shaped tip . The follow-up period was 1,3,6 months, and Postoperative examination including color fundus photography , fundus fluorescein angiography were performed. Results radial optic neurotomy was performed in all 10 patients successfully. The retinal vein permeation increased were found after optic neurotomy all patients , and the small hemorrhage was noted during the surgical procedure in 7 patients, and 9 patients had improve in the retina and macular edema and the appearance of the fundus in 1 month postoperatively and the retinal hemorrhage was significantly absorbed and macular edema disappeared in 3 months postoperatively as documented by photography , fluorescein angiography. Postoprative visual acuities were improved in 8 of 10 of patients (80%) and the visual acuities were not improved in 1 patient and the visual acuities were decreased in 1 patient with vitreous hemorrhage in 4 weeks postoperatively. Concluslons Radial optic neurotomy is a safe and effective operation may improve the retinal hemorrhage , macular edema and the visual acuity prognosis in patients with ischemic CRVO. [Key words] Central retinal vein occlusion Radial optic neurotomy |
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