摘要
目的探讨巨大视网膜裂孔的手术治疗及其效果。方法４１例巨大视网膜裂孔均行睫状体平坦部玻璃体切除联合硅油注入术，其中３５例予以巩膜环扎，１７例行晶体切除患者均进行了充分的基底部玻璃体及视网膜周围膜的切除。并分别通过气－液交换、视网膜图钉及液态氟化物等方法展平巨大裂孔翻转的瓣，使用冷凝或眼内激光封闭视网膜裂孔。结果术后随访３～３９个月（平均１１．６个月）２９例视网膜完全复位（７０．７３％），７例黄斑复位，５例未复位。复位的３６例中，术后视力０．０１～０．０５者６例；０．０６～０．１者１７例；；０．２～０．５者１１例；０．６～１．０者２例。结论巨大视网膜裂孔手术成功的关键是术中应完全展平翻转的瓣。巩膜环扎与否各有利弊，对于合并增殖性玻璃体视网膜病变的巨大裂孔有必要施行适度的巩膜环扎。术后进一步的增殖是影响巨大视网膜裂孔远期预后的主要原因。
Objective To study the effect of surgical management for giant retinal tear (GRT).Methods A standard three point vitrectomy with silicone oil intraocular injection was performed on 41 cases.Of them,scleral buckling was also performed on 35 cases and lensectomy,on 17 cases.The basal vitreous gel and peri retinal membranes were resected completely in all the cases.Air fluid exchange,retinal tack or liquid perfluorocarbon were used to unroll and flatten the flap of the GRTs.Cryopexy or endophotocoagulation were applied to close the GRTs.Results In the follow up for 3￣39 months (mean 11.6 months),total retinal attachment was achieved in in 29 cases,macular retinal attachment in 7 cases,and no retinal attechment in 5 cases.The final visual acuities were 0.01￣0.05 in 6 cases,0.06￣0.1 in 17 cases, 0.2￣0.5 in 11 cases and 0.6￣1.0 in 2 cases.Conclusions The key factor of successful operation is to unroll and flatten the flap of GRTs completely. Scleral buckling shouw advantages and disadvantages,while appropriate scleral buckling is necessary in GRTs with proliferative vitreoretinopathy. Postoperative further proliferation is the main factor affecting the long term effect the treatment.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
1997年第2期125-128,共4页
Chinese Journal of Ophthalmology
