摘要
目的伴视网膜下增殖的陈旧性孔源性视网膜脱离(rhegmatogenous retinal detachment,RRD)手术仍是难题,文中回顾性分析巩膜扣带联合冷凝放液术治疗陈旧性RRD伴明显视网膜下增殖的临床治疗效果。方法陈旧性RRD患者15例,玻璃体视网膜病变B级(包括B级)以下病例15例(15只眼),男12例,女3例;年龄17~45岁。近视患者14只眼,所有患眼均有明显视网膜下增殖,术前视力:6例≤0.01,6例为0.02~0.08,3例≥0.1。所有患者视网膜脱离范围在1/2象限及以上,黄斑脱离,手术方法为传统的巩膜扣带联合冷凝放液术。结果术后1个月,患者视网膜复位14例,成功率为93.33%,其中男11例,女3例。多数复位患者的术后视力较术前明显提高(Z=-3.24,P<0.01);1例未复位患者放弃再手术。光学相干断层成像(optical coherence tomography,OCT)的随访结果显示,当常规眼底检查正常时,黄斑区视网膜仍未完全复位。结论巩膜扣带术治疗陈旧性RRD伴视网膜下增殖安全有效,黄斑区视网膜的完全复位可能需要更长的时间。
Objective It remains a challenge how to manage by surgery longstanding rhegmatogenous retinal detachment(RRD) with subretinal fibrosis.This retrospective study is to evaluate the effectiveness of the scleral buckling procedure in the treatment of longstanding RRD with subretinal fibrosis.Methods Fifteen patients,12 males and 3 females,suffering from longstanding RRD with subretinal fibrosis in 15 eyes underwent the scleral buckling procedure combined with cryotherapy and drainage.The patients ranged in age from 17 to 45 years,with myopia in 14 eyes(93.3%) and with remarkable subretinal fibrosis in all.The retinal detachment was between 2 and 3 quadrants with macula detachment.Proliferative vitreoretinopathy was classified as grade B or A in all the cases.The preoperative visual acuity was ≤0.01 in 6 eyes,0.02-0.08 in another 6,and ≥0.1 in the other 3.Results One month after surgery,retinal reattachment was achieved in 14 eyes(11 in males and 3 in females),with a success rate of 93.3%,and most of the patients showed an obviously better visual acuity than before surgery(Z=-3.24,P<0.01).The one that failed in retinal reattachment refused reoperation.Optical coherence tomography(OCT) during the follow-up revealed that complete retinal reattachment obviously lagged behind the normal findings of the routine ocular fundus examination.Conclusion Scleral buckling procedure is safe and effective for the treatment of longstanding RRD with subretinal fibrosis,though it may take a longer time to achieve complete macular reattachment.
出处
《医学研究生学报》
CAS
2011年第6期593-596,共4页
Journal of Medical Postgraduates
基金
南京军区南京总医院科研基金(2009Q037)
关键词
孔源性视网膜脱离
视网膜下增殖
巩膜扣带术
Rhegmatogenous retinal detachment
Scleral buckling
Subretinal fibrosis
