| Circumferential Buckling on Equator: IV. Surgical approach for Retinal Periphlebitis with massive Vitreous Hemorrhage. |
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Si Yeol Kim |
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Department of Ophthalmology, School of Medicine, Kyung Book University, Korea. |
| 안구적도상에 (眼球赤道上) 시술하는 위도공막돌융술식 (緯度鞏膜突隆術式) - Ⅳ. 초자체출혈이 심한 강막정맥주위염의 (綱膜靜脈周圍炎) 외과적 치료법 |
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김시열(Si Yeol Kim) |
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| Abstract |
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The treatment of the retinal periphlebitis is a symptomatic one including systemic corticosteroid therapy, photocoagulation, and surgery which aims at prevention of the complete destruction of the eye and the resultant blindness by making the patient pass the active stage (about 3 years) of the disease without a problem. In case of severe vitreous hemorrhage, effective photocoagulation is impossible and Franceschetti reported that he had succeeded, to a certain extent, in stopping the hemorrhage by the method of "Overcast skies coagulation" applying diathermy to the sclera in the upper half of the globe extensively. Because the vitreous hemorrhage in retinal periphlebitis is usually repetitive, it is usual to find the fibrous proliferation and retinal detachment already when the blood in the vitreous is absorbed. In such cases, the Overcast skies coagulation alone is not satisfactory in achieving the goals of the therapy. The author tried to manage the vitreous hemorrhage and tractional retinal detachment by combining the Overcast skies coagulation with scleral buckli ng procedure. The surgical techniques include the lamellar scleral incision in the equatorial area in the equatorial area in the upper half of the globe, extensive application of the diathermy or cryothermy to the sclera exposed, and implantation of the allogeneic sclera and encircling band along the equator. Additioal procedure can be applied also in the lower half of the globe. Twelve cases of retinal periphlebitis with massive vitreous hemorrhage were treated by surgical method, and followed up at least 1 year. Of these 12 cases, the retina was reattached in 10 cases and the vision was maintained ot increased in 8 cases. |
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