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玻璃体手术用以治疗增殖性糖尿病视网膜病变的并发症,当自然病史预后很差其它疗法无效并发生明显视力下降时行玻璃体手术是用一小直径器械从睫状体平部伸人玻璃体腔。这些器械具有切开和取除异常组织,用一特殊灌注液置换切除组织,和用导光纤维进行眼内照明。各种器械附件和技术施眼内透热和光凝并处理视网膜脱离及其他异常。使用这些手术方法,可去除眼内混浊,如玻璃体出血和后发性白内障,并切开异常纤维血管组织和/或玻璃体膜。因而一些以玻璃体出血、纤维血管组织生长及视网膜脱离等为特征的致盲情况可获逆转。玻璃体手术通常是在视力≤0.1的情况下建议使用。常用于不能清除的玻璃体出血和进行性视网膜脱离。所获结果取决于手术的特异适应症,也取决于每例玻璃体视网膜异常的复杂性。当然已获可重复性的结果。2/3进行手术的糖尿病眼至少获部分视功能改善。于仅有玻璃体出血的眼高达80％病例获成功的结果,70％有牵引性网膜脱离的眼可成功的治疗,50％患复杂孔源性网膜脱离的眼可成功的治疗。玻璃体手术对于有增殖性糖尿病视网膜病变的眼还有重要远期影响。当解除全部玻璃体牵引并切除后玻璃面后,从视网膜再生出纤维血管组织是罕见的。远期效果显示当开始即获效果时,90％眼可维持在改善的水平。似乎后玻璃体面是纤维血管组织增生的所需支架。当用外科方法将其去除(或自然与视网膜分离),可显著阻止纤维血管组织的生长。
Vitreous surgery is used to treat complications of proliferative diabetic retinopathy. When the natural history is poorly prognosticated and other therapies ineffective and apparent vision loss occurs, vitrectomy is performed with a small diameter instrument into the vitreous cavity from the ciliary body flat. These devices have the ability to incise and remove abnormal tissue, replace the tissue with a special perfusion solution, and use light guide fibers for intraocular illumination. A variety of device accessories and techniques intraocular heat and photocoagulation and treatment of retinal detachment and other abnormalities. Using these surgical procedures, intraocular opacities, such as vitreous hemorrhage and subsequent cataract, can be removed and abnormal fibrous vascular tissue and / or vitreous membranes dissected. Thus, some blinding situations characterized by vitreous hemorrhage, fibrovascular tissue growth and retinal detachment may be reversed. Vitreous surgery is usually recommended for visual acuity ≤0.1. Commonly used in unresectable vitreous hemorrhage and progressive retinal detachment. The results obtained depend on the specific indications for the procedure and on the complexity of each vitreoretinal abnormality. Of course, reproducible results have been obtained. Two-thirds of diabetic eyes undergoing surgery had at least partial visual function improvement. Results were achieved in up to 80% of cases with vitreous hemorrhage alone, in 70% of eyes with successful traction retinal detachment, and in 50% of eyes with complicated rhegmatogenous retinal detachment. Vitreous surgery also has important long-term effects on the eyes of proliferative diabetic retinopathy. It is uncommon to regenerate fibrovascular tissue from the retina after lifting the entire vitreous traction and resecting the posterior facet. The long-term results show that 90% of the eyes can be maintained at an improved level when the effect begins. It appears that the posterior vitreous is the required scaffold for the proliferation of fibrovascular tissue. When surgically removed (or naturally isolated from the retina), fibrovascular tissue can be significantly prevented from growing.