摘要
目的探讨玻璃体手术治疗眼内晚期视网膜母细胞瘤的效果。方法 2012年7月至2013年6月,选择眼内晚期（D期或E期）视网膜母细胞瘤患儿11例（12眼）,采用博士伦23G玻璃体切割系统,进行玻璃体视网膜手术,包括玻璃体切割、肿瘤切除、视网膜光凝、眼内填充等。手术后随访6~18个月（平均9.4个月）。结果所有患眼均完成视网膜肿物切除。术后10眼视网膜裂孔封闭、视网膜复位;2眼因肿瘤范围大,视网膜大部分切除。8眼硅油填充,2眼行C3F8填充,2眼未作眼内填充。随访末,病情稳定者8眼,肿瘤复发4眼,眼球摘除1眼,因肿瘤眼外转移去世1例,2眼再行玻璃体内注射马法兰。硅油取出3眼,硅油置换1眼,4眼硅油长期填充。视力保持0.2以上5眼,患儿因年龄小不配合视力检查者7眼。并发白内障2眼,行白内障摘出术。结论玻璃体手术能够有效切除眼内晚期视网膜母细胞瘤,对保留眼球和患眼视力,提高患儿生存率有一定帮助,但其安全性和长期疗效还有待进一步研究。
Objective To investigate the effects of vitreous surgery for advanced intraocular retinoblastoma. Methods From July 2012 to June 2013,11 cases（ 12 eyes） with advanced intraocular retinoblastoma（ stage D or E） were collected. Vitreoretinal operation was performed using the Bausch ＆ Lomb 23 G vitrectomy system, including vitrectomy, retinal tumor resection,photocoagulation and intraocular tamponade. After operation the follow-up time ranged from 6months to 18 months（ averaged 9. 4 months）. Results Retinal tumor resection was completed in all patients. Retinal holes were closed and retina reattached in10 eyes. The tumor was too large and more retinal excisions were made in 2 eyes. There were 8 eyes with silicone oil tamponade,2eyes with C3F8 tamponade and 2 eyes with no tamponade. At the end of follow-up,the disease was stable in 7 eyes,tumor recurred in 4 eyes,1 eye underwent enucleation and 1 case died from tumor extraocular metastasis. Three eyes underwent silicone oil removal,1 eyes underwent silicone oil replacement. Visual acuity remained above 0. 2 in 5 eyes,7 cases were too young to be able to check visual acuity. Complicated cataract occurred in 2 eyes,the cataract extractions were performed. Conclusion Vitreous operation can effectively remove advanced intraocular retinoblastoma,retain the eyeball and visual acuities, and help to improve the survival rate,but its safety and long-term efficacy need to further study.
出处
《眼科新进展》
CAS
北大核心
2014年第8期764-765,768,共3页
Recent Advances in Ophthalmology
基金
深圳市卫人委项目(编号:201302133)~~
