A Study Of Retinal Vein Occlusion After Pars Plana Vitrectomy

Retinal vein occlusion is a kind of retinal vescular disease that with severe vision loss, which due to mecular oedema, vitreous hemorrhage, neovascular glaucoma. Pars Plana Vitrectomy can treat the muddy dioptric media caused by vitreous hemorrhage very well, meanwhile, proliferative vitreoretinopathy will barely happen after necessary laser.So it will be good to treat the vitreous hemorrhage with Pars Plana Vitrectomy. Of cause the whole condition of the body should also be controled well.Objective:To analyze the risk facts of retinal vein occlusion after Pars Plana Vitrectomy,complications after the surgery and the facts prognosis depending on.Methods:Research in total 143 cases of retinal vein occlusion after pars plana vitrectomy from November,2004 to January,2009.Record information about age,sex, main complications, the whole course of the surgeries,best correct visual acuity and complications after surgeries.Results:Checking on the changes of retinas with slit lamp and supplementary lens before and after surgeries everyday. According to the locations of vein occlusion, there are 67 eyes at superior temporal(45.9%),24 eyes at lower temporal(16.4%),5 eyes at superior nasal(3.4%),2 eyes at lower nasal(1.4%), 41 eyes as hemicentral vein occlusion(28.1%) and 7 eyes as central retinal vein obstruction(4.8%).There are 90 patients with hypertension(61.3%),15 patients with diabetes mellitus(10.3%), 6 patients coronary heart disease(3.8%),1 patient with rheumatism(1.0%),6 patients with cerebral thrombus (3.8%) and 4 patients with glaucoma(2.5%).In terms of time before the patients went to hospital, there are 58 eyes in 0 to 3 months, 14 eyes with proliferative membrane, 10 eyes treated with Phaco,11 eyes with retina hole. There are 21 eyes in 3 to 6 months, 9 eyes with proliferative membrane, 5 eyes treated with Phaco,7 eyes with retina hole. There are 67 eyes in more than 6 months, 28 eyes with proliferative membrane, 5 eyes treated with Phaco,6 eyes with retina hole. There were 14 eyes(9.6%)with retinal detachment before the surgery, which were all with proliferative membrane. Retina holes were found in 10 eyes of these 14 eyes. 31 eyes occurred high intraocular pressure in total.21 eyes happened in 72 hours after surgery, among which 14 eyes were fixed with C3F8 in surgery.7 eyes happened in 3 days to 1 week after surgery, among which 5 eyes were fixed with C3F8 in surgery. 3 eyes happened in 1 week to 2 weeks after surgery, which were all fixed with C3F8 in surgery.6 eyes fixed with silicon oil didn't occur high intraocular pressure. 23 cases used reptilase because of the second vitreous hemorrhage in total.20 cases used in 1 day to 3days after the surgery.3 cases used in 3 days to 6 days after the surgery.5 cases occurred second vitreous hemorrhage 2 months after surgery, among which 4 eyes treated with vitreous lavation, and 1 eye recovered with medicine. Retinal detachment happened with 4 eyes(2.7%)again 1 month later after the surgery.2 eyes of them were treated with scleral buckling and retinal explants. They were all fully recovered.1 eye was treated with Pars Plana Vitrectomy again and fixed with silicon oil which has been taken out now. The retina is reattached. The last eye did not have second because of some reasons. The difference is unconspicuous through the statistical test P>0.05 in before surgery and after surgery about best correct visual acuity of central retinal vein occlusion. The difference is conspicuous through the statistical test P<0.05 in before surgery and after surgery about best correct visual acuity of hemicentral vein occlusion. The difference is conspicuous through the statistical test P<0.05 in before surgery and after surgery about best correct visual acuity of branch vein occlusion. Best correct visual acuity of central retinal vein occlusion eyes were all below 0.05. Best correct visual acuity of 20 eyes with hemicentral vein occlusion were below 0.05(48.8%),18 eyes were between 0.05 to 0.3(43.9%),3 eyes were between 0.3 to 0.5(7.3%). Best correct visual acuity of 42 eyes with branch retinal vein occlusion were below 0.05(42.9%),47 eyes were between 0.05 to 0.3(48.0%),7 eyes were between 0.3 to 0.5(7.1%),4 eyes were over 0.5(4.1%).Conclusions1.There are closed correlate between the occurrence of retinal vein occlusion and the appearance of retinal vein.2.Prevention of hypertension, controlling pressure strictly and examining retina regularly will be very useful for prevention of retinal vein occlusion.3.Once patients notice appearance of vitreous hemorrhage, they should go to hospital regularly in order to make the doctors decide a good time for surgery.4.Controling the mode of surgery to avoid making the disease worse.In a word, hypertension is one of the most important risks of retinal vein occlusion, so therapy of hypertension is very important. As a result complication will reduce a lot. To control the time to start the surgery is active to reduce proliferative vitreoretinopathy, to improve success rate of surgery and to reduce fixing.