摘要目的 探讨全氟萘烷(Perfluorodecalin,PFDL)在睫状体扁平部玻璃体切除术(ParsPlana Vitrectormv,PPV)中的独特作用及在眼内长期残留时对眼组织的影响.方法 回顾分析在PPV中应用PFDL的临床病例239例239只眼,其中裂孔源性视网膜脱离(retinaldetachment,RD)130例,晶状体脱位于玻璃体腔4例,外伤性RD41例,增殖性糖尿病性视网膜病变导致玻璃体出血合并牵拉性RD21例,视网膜静脉栓塞和视网膜静脉周嗣炎导致玻璃体腔出血合并牵拉性RD27例,陈旧性脉络膜出血1例,急性视网膜坏死合并视网膜脱离2例,眼内炎3例,Coats病合并牵拉裂孔性RD1例,眼内填充硅油合并RD9例.采用PPV,膜剥离,PFDL使用,眼内激光,气液交换,惰性气体及硅油眼内填充.探讨防止PFDL眼内残留的方法 ,对黄斑裂孔或后极部裂孔采用"气液交换后置换PFDL法",对巨大裂孔性视网膜脱离采用"PFDL联合部份气液交换法",对360°视网膜切开采用"逐步使用PFDL法".结果 随访12～15个月,212例212只眼获得随访,视网膜复位181例181只眼,有效率85.37%,术后PFDL残留22只眼,随访期间,角膜、前房及视网膜均未见功能及结构上的改变.结论 PFDL可有效地应用于PPV中,提高治疗巨大裂孔性视网膜脱离、外伤性视网膜脱离、眼内填充硅油合并RD等复杂性视网膜脱离的手术成功率,PFDL小滴在眼内长期存留,临床上未观察到明显眼部损害.

abstractsObjective To investigate the role ofperfluorodecalin (PFDL)in Pars Plana Vitrectormy(PPV),and influence of remnent of PFDL.Method 239 eyes were reviewed,who had undergone PPV, andPFDL was used in PPV,among them 130 eyes were complicated retinal detachment (RD),4 eyes weredislocated lens in vitreous,41 eyes were traumatic retinal detachment,21 eyes were proliferative diabeticretinopathy,27 eyes were retina vaseular disease uniting tractional retinal detachment, 1 eye was old choroidhemorrhage,2 eyes were acute retinal necrosis syndrome uniting retinal detachment,3 eyes wereendophthalmia, 1 eye was Coats disease,9 eyes were RD uniting silicone oil tamponades.PPV involving thepeeling of pre-retinal membrane,PFDL injection,endolaser, fluid～air exchange,and inert gas or silicone oiltamponades.Probed the way of avoiding remnent of PFDL in PPV, "permutation of PFDL after air-fluidexchange " was used in PPV of macular hole or posterior pole hole, "part air-fluid exchange associate with theuse of PFDL"was used in PPV of grand retina tear," PFDL was used step by step "in PPV of 360o retinotomy,Results 212 eyes were followed for 12～15mons,retinal attachment was achieved in 181 eyes,the efficiencywas 85.37%, Remnent of PFDL were found in 22 eyes, no functional and morphological changes of cornea 、anterior chamber and retina were found in follw-up period.Conelution PFDL can be safely and effectivelyused in PPV,grant retinal tear RD,RD caused by trauma ,and RD uniting silicone oil tamponades can besuccessfully treated by using PFDL,remnent of PFDL in the anterior chamber and vitreous cavity are welltolerated and do not induce ocular damage.