[关键词]
[摘要]
玻璃体切除术发明至今已经有50余年的历史,目前在眼科的应用指征涵盖了大部分玻璃体视网膜疾病。尽管随着设备的革新和技术的进步,玻璃体切除术的手术风险已经降至很低,但仍有一些并发症难以避免,意外或原因不明的视功能下降时有发生。玻璃体切除术后视神经病变的发生率较高,可发生于术后即刻或数周至数月,会引起不可逆的视觉损伤。致病原因大致可分为术中视神经损伤和术后继发损伤。术中视神经损伤包括机械性损伤、染料毒性及眼内压影响,术后继发损伤包括眼内压升高、硅油毒性及氧化应激等微环境改变对视神经的损伤。文章将对玻璃体切除术相关视神经病变的临床表现、常见原因及相关管理做一综述,以期引起眼科医生们对于此类疾病的关注。
[Key word]
[Abstract]
Over half a century has passed since the inception of vitrectomy, and the indications for its utilization in ophthalmology encompass the majority of vitreoretinal disorders. Technological advancements and equipment innovation have drastically reduced the surgical risk of vitrectomy, but some complications remain unavoidable. Occasionally, unexpected or unexplained visual impairments can manifest. Vitrectomy is associated with a high incidence of optic neuropathy, which can manifest weeks to months following the procedure and result in permanent visual impairment. An intraoperative optic nerve injury and a postoperative secondary injury comprise the causes. Intraocular pressure, dye toxicity, or mechanical damage can cause intraoperative optic nerve injury. Secondary injuries that occur after surgery include an increase in intraocular pressure, toxicity to silicone oil, oxidative stress, and other alterations in the microenvironment. This review will discuss the common causes, clinical manifestations, and related management of optic neuropathy connected to vitrectomy in order to attract the interest of ophthalmologists.
[中图分类号]
[基金项目]
沈阳市中青年科技创新人才支持计划项目(No. RC210267); 沈阳市卫健委科研课题计划(No. 2022103)