Click the blue words above to pay attention to us recently. Mr. Zou, who lives in Fenghuang Industrial Park, met with a problem. 20 days ago, his left eye began to see things more and more blurred. He thought he got presbyopia when he was old, but Mr. Zou changed several presbyopia glasses, and his right eye was still clear and his left eye was blurred. What's wrong with it? With doubts, Mr. Zou came to Dongchangfu people's Hospital for ophthalmology. Liu Zhenbao, director of Ophthalmology of the hospital, inquired about Mr. Zou's past medical history. Mr. Zou, 63, was diagnosed with hypertension and diabetes four years ago. According to the situation described by Mr. Zou, director Liu carried out a detailed inspection for Mr. Zou, and found that Mr. Zou's vitreous body was turbid through the front mirror of the slit lamp. Director Liu further carried out an ophthalmic B-ultrasonic examination for Mr. Zou, and finally diagnosed him with vitreous hemorrhage. "Mr. Zou's disease is caused by diabetic retinopathy, which is one of the most common serious complications of diabetes. Diabetic retinopathy is caused by ischemia and anoxia of part of retina after microvascular damage of retina, and then secretion of vascular growth factor, resulting in the formation of non functional neovascularization. Neovascularization is easy to rupture and bleed repeatedly, resulting in vision decline, retinal traction and detachment, and may eventually lead to blindness. So diabetic retinopathy is an eye disease that can cause blindness, and the damage of this visual function is irreversible! " Director Liu said. Director Liu said: "the average prevalence of diabetic retinopathy accounts for about 50% of diabetic patients, but most diabetic patients never do eye examination. But the disease is insidious, early patients may not have any eye symptoms, in fact, 30% of patients without eye symptoms may have diabetic retinopathy
After hospitalization, director Liu controlled the blood pressure and blood sugar of Mr. Zou. After the index was stable, director Liu carried out vitrectomy + silicone oil injection + macular membrane peeling for Mr. Zou, which was the first time for ophthalmology department of Dongchangfu people's hospital to carry out this technology. The next day after the operation, after Mr. Zou took off his blindfold, his vision had completely recovered.
Popular science time
What is the vitreous body? The vitreous body is a large piece of tissue of the eyeball, which is a colorless transparent colloidal body, located behind the lens, filled between the lens and the retina, filled with the cavity behind the lens, and has the function of refraction and fixation of the retina.
Under normal circumstances, the vitreous body has good transparency, making the retina and choroid adhere to each other. If the vitreous changes, people who despise things will feel mosquitoes flying in front of their eyes. People who are serious can completely block the light and lose their sight. It may also cause peripheral tissue changes, such as retinal detachment, and damage the whole eyeball.
What is vitrectomy? What are the advantages? Vitrectomy is a high-level modern micro ophthalmic surgery developed in the early 1970s. Its emergence is considered as a revolution in the history of ophthalmic treatment, breaking many previously untreatable surgical areas and bringing light to countless patients with eye diseases. In the eye treatment centers of developed countries, vitrectomy is the second major eye surgery after cataract extraction and intraocular lens implantation.
Its basic function is to remove the turbid vitreous or pull the vitreoretinal, restore the transparent refractive stroma and promote the reduction of the retina, treat the vitreoretinal diseases, so as to restore the visual function of the patients.
As a high precision operation in Ophthalmology, the advantages of vitrectomy are obvious. In particular, the advantages of vitrectomy are as follows:
1. Vitrectomy is performed under local anesthesia, with small trauma, high safety and wide operation indications;
2. With the progress of the society and the aggravation of the aging process, there are more and more senile maculopathy, more and more myopic patients and diabetic patients, and more and more vitreoretinal diseases. Vitrectomy can greatly improve the symptoms of this kind of patients and avoid more blindness or atrophy of eyeball caused by this disease;
3. By removing turbid or organic vitreous body, pus and hematocele, bacteria and toxins can be removed, and the transparency of the refractive stroma in the vitreous cavity can be restored;
4. Take out the foreign body accurately under direct vision to avoid blindness and reduce the damage to the surrounding tissue to the lowest point;
5. It can improve the extraction rate of foreign bodies in the vitreous cavity, and can remove multiple and multiple foreign bodies at the same time, especially non-magnetic foreign bodies, wrapped foreign bodies, retinal embedded foreign bodies, etc;
6. It can directly and accurately obtain the samples of vitreous lesions and improve the positive rate of pathogenic examination;
7. It can be operated on traumatic cataract, retinal detachment, retinal hole and silicone oil filling at the same time, so as to reduce the number of operations, avoid the damage of intraocular structure caused by multiple operations, reduce the cost of hospitalization, and restore the visual function of patients to the maximum extent.
Because vitrectomy is a high-level modern micro ophthalmic surgery, which is difficult, long time, expensive equipment, high technical content and high requirements for surgeons, it has gradually become a manifestation of the technical level and comprehensive strength of a hospital.
The scope of application of vitrectomy the indication of vitrectomy is expanding day by day, the scope of operation is almost all over the eyeball except cornea and sclera. Specifically, the indications are divided into anterior segment and posterior segment.
Anterior segment indication
1. Soft cataract. Vitrectomy can remove crystal cortex completely, make pupil collar completely transparent, without hindsight;
2. Pupil membrane. The pupil membrane caused by various reasons can be removed;
3. Perforating injury of anterior segment. In the case of perforating injury of anterior segment with traumatic cataract, especially vitreous prolapse, lens and anterior vitrectomy should be done immediately after suturing the wound, which can improve vision and reduce posterior cataract;
4. The crystalloid detachment is located in the anterior chamber. If there is no hard nucleus, the crystal can be resected;
5. Vitreoretinal contact syndrome. In cataract surgery, if the vitreous enters the anterior chamber through the pupil and contacts with the corneal endothelium, the function of corneal endothelium will be decompensated. Therefore, all the vitreous bodies entering the anterior chamber should be removed;
6. Malignant glaucoma. The anterior vitreous cortex was excised, the obstruction of aqueous humor drainage was relieved, and the high intraocular pressure was controlled.
Indication of posterior segment of eye
1. Vitreous hemorrhage. It is a main indication of vitrectomy. After 3-6 months of conservative treatment, vitrectomy should be done. But once the retinal detachment is observed, the operation should be performed in time. In order to prevent amblyopia, children should operate as soon as possible. Traumatic vitreous hemorrhage can be operated earlier;
2. Intraocular foreign bodies. Vitrectomy is performed under direct vision, especially for non-magnetic foreign bodies or other eye tissue injuries;
3. Endophthalmitis. The operation can remove bacteria and toxins, remove necrotic tissues and inflammatory substances, and inject drugs directly into the vitreous cavity;
4. Retinal detachment. Retinal detachment with vitreous opacity, giant hole with proliferative vitreoretinopathy, macular hole, traction retinal detachment caused by vitreous proliferation, and retinal detachment caused by diabetic retinopathy are suitable for vitrectomy. Some recurrent retinal detachment can also choose vitrectomy;
5. others. When the lens dislocates to the vitreous body and cataract surgery, there are fragments falling into the vitreous body, macular fold, macular anterior membrane and macular dry hole, cysticercus cellulosae in vitreous body and other diseases, which are also indications of vitrectomy.
Editor: Xie Xinkai
Editor in charge: Wang Jingzhuang
Email: dcfrmyyxck@126.com
Hospital address: No.128 Songgui Road, 1km west of Dongchangfu District People's Government
Tel: 400-0635-120
　　　　　　 8223822
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