| Background and objectiveTerson syndrome is acute intracranial hemorrhage and subarachnoid hemorrhage combined with vitreous blood disease,also known as eye-brain syndrome.Due to acute intracranial hemorrhage and subarachnoid hemorrhage,the intraocular venous pressure increased sharply,resulting in ocular hemorrhage in the peripheral and retinal blood vessels rupture,which caused severe vision loss when the blood in the retina or before the retina entered the vitreous body.Severe glass volume blood treatment is vitrectomy,Eckardt first reported in 2005 to 23G Conjunctival free vitrectomy for clinical use,the operation has a small incision,.free suture and the advantages of rapid healing.The effect and prognosis of 23G minimally invasive vitrectomy in the treatment of Terson syndrome were analyzed retrospectively,and the related problems after operation were preliminarily discussed.MethodInclusion criteria:Clinical Retrospective Analysis Patients diagnosed as Terson syndrome in 18 cases(21 eyes)were diagnosed in our hospital from July to July in the period from July to October in 2017.All cases were diagnosed by the Department of Ophthalmology and Neurosurgery.Exclusion criteria:1.Exclude retinal vein occlusion,intraocular tumors,age related macular degeneration,coagulation dysfunction of the blood system diseases,diabetic retinopathy.2.Purscher retinopathy was excluded.3.Eliminate all kinds of blunt force directly caused eye contusion and so on.Operative methodThese patients underwent 23G minimally invasive vitrectomy(23G TSV).During the surgery,the condition of the retina was considered for the filling of silicone oil and stripping membranes,and the pre-macular "membrane"-like substance torn off during surgery was used in addition to routine pathological examination.S100 was immunohistochemically stained for histological examination to identify the presence of neurogenic components(excluding retinal nerve fibers).All enrolled patients were performed satisfactorily,and all cases were not filled with silicone oil.After the surgery,the patient was gas-liquid exchanged and the patient was prone or recumbent for 3-5 days.The patients were subjected to best-corrected visual acuity(BCVA),intraocular pressure(IOP),indirect ophthalmoscopy,slit lamp microscope,and optical coherence tomography before and after surgery.OCT)and some patients underwent optical coherence tomography angiography(OCTA).Result23G minimally invasive vitrectomy average time(48.1 ± 21.2)min,postop erativeintraocular pressure(13.1 ± 3.6)mmHg,random visits 3-8(average 5.5)mo;most patients after vision vision most of the vitreous cavity clear and found Their visual acuity was greatly improved.In January,the best corrected visual acuity was>0.5 in 13 eyes,0.1-0.4 in 7 eyes,and<0.1 in 1 eye.In 4 cases,transient low intraocular pressure occurred early after surgery,and all of them returned to normal after bandage compression.No complications such as intraocular hemorrhage and endophthalmitis were found.Postoperative pathological examination showed that the membranous components contained no nerve fiber components.Conclusion23G minimally invasive vitrectomy can effectively help restore vision in patients with Terson syndrome.It is one of the more scientific,safe,and effective treatment methods in the medical field.However,if the patient is bleeding heavily and may not be self-absorbed,23G minimally invasive vitrectomy should beperformed early.Three months after the vitreous hemorrhage,depending on the vision recovery situation to decide whether to perform surgical treatment,you can safely perform surgery,including one case of 1.5 months after surgery,also achieved good results,suggesting that early surgery is not completely surgery Taboo.The macular epicardial material is mainly composed of inner limiting membrane components and fibrin proliferation,and can be stripped as needed. |
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