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中华眼科医学杂志(电子版)

中华眼科医学杂志(电子版) ›› 2020, Vol. 10 ›› Issue (06) : 339 -344. doi: 10.3877/cma.j.issn.2095-2007.2020.06.004

论著

曲安奈德联合吲哚菁绿复合染色技术在黄斑前膜手术中应用的临床研究
张永鹏1, 孙艺梦2, 贾力蕴1, 周海英1, 马凯1,†()   
  1. 1. 100730　首都医科大学附属北京同仁医院　北京同仁眼科中心　北京市眼科学与视觉科学重点实验室
    2. 510060　广州，中山大学中山眼科中心　国家眼科学重点实验室
  • 收稿日期:2020-09-17 出版日期:2020-12-28
  • 通信作者: 马凯
  • 基金资助:
    国家自然科学基金面上项目(81670738)

The application of double vital staining technique in macular epiretinal membrane surgery

Yongpeng Zhang1, Yimeng Sun2, Liyun Jia1, Haiying Zhou1, Kai Ma1,†()   

  1. 1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China
    2. Zhongshan Eye Center, Sun Yatsen University, National Key Laboratory of Ophthalmology, Guangzhou 510060, China
  • Received:2020-09-17 Published:2020-12-28
  • Corresponding author: Kai Ma
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引用本文：

张永鹏, 孙艺梦, 贾力蕴, 周海英, 马凯. 曲安奈德联合吲哚菁绿复合染色技术在黄斑前膜手术中应用的临床研究[J]. 中华眼科医学杂志(电子版), 2020, 10(06): 339-344.

Yongpeng Zhang, Yimeng Sun, Liyun Jia, Haiying Zhou, Kai Ma. The application of double vital staining technique in macular epiretinal membrane surgery[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2020, 10(06): 339-344.

目的

探讨在黄斑前膜(ERM)手术过程中，同步行曲安奈德(TA)联合吲哚菁绿(ICG)后极部黄斑区复合染色的应用价值。

方法

回顾性病例分析。收集2015年12月至2018年12月于首都医科大学附属北京同仁医院眼科中心采用复合染色技术行ERM术21例(21只眼)患者的病例资料。其中，男性5例(5只眼)，女性16例(16只眼)；年龄53~79岁，平均年龄(66.0±13.9)岁。观察并记录所有患者手术前后最佳矫正视力、光学相干断层扫描检查结果及并发症的情况。

结果

21例患者均行23G玻璃体视网膜手术。其中，术中联合超声乳化白内障吸除及人工晶状体(IOL)植入者8例(8只眼)，占38.09%(8/21)；术前为IOL眼者3例(3只眼)，占14.29%(3/21)；术后二期行白内障手术者3例(3只眼)，占14.29%(3/21)；未行白内障手术者7例(7只眼)，占33.33%(7/21)。术后随访13~36个月，平均随访时间18.52个月。术后最佳矫正视力提高者13例(13只眼)，占61.90%(13/21)；最佳矫正视力不变者6例(6只眼)，占28.57%(6/21)；最佳矫正视力降低者2例，占9.52%(2/21)。术后光学相干断层扫描检查结果显示ERM均已去除，随访期内无复发，术中术后无并发症发生。

结论

TA联合ICG复合染色技术在ERM手术中应用安全有效，具有临床应用价值。

关键词: 黄斑前膜, 染色技术, 曲安奈德, 吲哚菁绿, 玻璃体视网膜手术
Objective

The aim of this study was to investigate the application value of triamcinolone acetonide (TA) combined with indocyanine green (ICG) for posterior pole macular double vital staining during macular epiretinal membrane (ERM) surgery.

Methods

Retrospective cases series. From December 2015 to December 2018, 21 cases of ERM surgery were collected in Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University. Among of them, there were 5 males (5 eyes) and 16 females (16 eyes) with an average age of (66.0±13.9) years-old whose age range of was 53 to 79 years-old. The best corrected visual acuity (BCVA), optical coherence tomography (OCT) and complications were evaluated.

Results

All patients underwent 23G vitrectomy, in which 8 cases (8 eyes) accounting for 38.09% (8/21) underwent intraoperative phacoemulsification combined with intraocular lens implantation, 3 cases (3 eyes) accounting for 14.29% (3/21) with intraocular lens (IOL) before operation, 3 cases (3 eyes) accounting for 14.29% (3/21) with postoperative cataract surgery, and 7 cases accounting for 33.33% (7/21) with non-cataract surgery. The follow-up time after surgery was 13 to 36 months with average time of 18.52 months. There were 13 cases (13 eyes) whose BCVA was increased accounting for 69.10% (13/21), 6 cases (6 eyes) remained unchanged accounting for 28.57% (6/21), 2 cases (2 eyes) decreased accounting for 9.52% (2/21). OCT showed that the ERM had been removed completely. It was not found that recurrence during the follow-up period and complications occurred during and after the operation.

Conclusions

Double vital staining technique was a safe and effective method in ERM surgery, which has clinical application value.

Key words: Macular epiretinal membrane, Staining technique, Triamcinolone acetonide, Indocyanine green, Vitreous retinal surgery
图2 患者手术前后光学相干断层扫描检查图　图2A示有黄斑前膜；图2B为术后3个月检查示黄斑前膜已去除
表1 21例患者一般资料及手术前后检查的结果
序号 性别 年龄(岁) 眼别 术前BCVA 视力下降时长(个月) 视物变形时长(个月) 联合白内障手术 术后二期白内障手术 术后随访时间(个月) 术后BCVA 术后视物变形的改善情况
1 女 58 左 0.25 12   否(术前IOL眼)   15 0.80  
2 女 64 右 0.40   36 是   18 0.30 变形好转
3 女 66 右 0.30   12 是   15 1.50 变形好转
4 女 57 右 0.20 2 2 否 否 19 0.40 不变形
5 女 71 左 0.10 6   否 否 18 0.30  
6 女 56 左 0.25 12   否 是 24 0.70  
7 男 72 左 0.06 1   是   24 0.30  
8 女 65 左 0.20   2 否 是 13 0.60 无改善
9 男 58 右 0.30 24   否 否 13 0.10  
10 女 59 左 0.01 12   否(术前IOL眼)   13 0.01  
11 女 58 左 0.20 8   否 是 13 0.70  
12 女 65 右 0.10 5   否 否 13 0.10  
13 女 60 左 0.30 3 3 否 否 14 0.30 不变形
14 女 74 右 0.10 12   是   18 0.10  
15 男 79 左 0.20 5 5 是   13 0.30 变形好转
16 女 78 左 0.05 24   是   36 0.10  
17 女 55 左 0.15 5 5 否 否 14 0.15 不变形
18 女 79 右 0.10 24 24 是   24 0.10 无改善
19 男 62 右 0.05 2   否(术前IOL眼)   24 0.60  
20 女 53 左 0.10 1 1 否 否 35 0.90 变形好转
21 男 70 左 0.10 3   是   13 1.00  
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