摘要
目的 探讨玻璃体切除术后裂孔性视网膜脱离外路显微手术的适应证及临床效果.方法 回顾性系列病例研究.收集2010年9月至2013年7月间在宜昌市中心医院眼科行外路显微手术治疗的23例（23只眼）玻璃体切除术后,发生裂孔性视网膜脱离患者的临床资料.分析视网膜脱离的原因、视网膜复位的效果、视力改善情况以及手术并发症等.结果 所有病例手术后随访3至12个月,平均（4.57±1.70）个月;一次手术视网膜解剖复位20例,手术成功率86.96％ （20/23）;其它3例需再次行内路玻璃体切除联合硅油填充术;视力提高13只眼（56.52％）,不变7只眼（30.43％）,下降3只眼（13.05％）.术后发生黄斑前膜1例（1只眼）,并发性白内障2例（2只眼）,未见其他严重并发症发生.结论 对于PVR≤C1、裂孔位于赤道附近或赤道前的玻璃体切除术后裂孔性视网膜脱离同样可采用外路显微手术使视网膜复位,且具有操作方便、效果良好、并发症少等优点,可减少再次玻璃体切除术的机会.
Objective To evaluate the effects of external-route microsurgery for the treatment of rhegmatogenous retinal detachment in selected eyes which had undergone vitrectomy.Methods A retrospective observational case series of 23 cases（23 eyes）had undergone vitrectomy as the first surgery for the treatment of various vitroretinal diseases.After the failure of the first surgery,external-route microsurgery was performed for the treatment of rhegmatogenous retinal detachment between September 2010 and July 2013.Under surgical microscope,the encircling and its suture were preplaced,then drainage of subretinal fluid or aqueous fluid,retinal cryotherapy,buckling,examination of locating the roles,encircling and intraocular injection of expanding gases or gas were performed.The retinal reattachment rate,visual outcome and postoperative complications were investigated.Results After 3 to 12（4.57±l.70）months follow-up period,the retinal reattachment rate was 86.96%（20/ 23 cases）.Further vitrectomy surgeries were needed for other 3 eyes.Macular epiretinal membrane happened postoperatively in one eye,complicated cataracts were found in two eyes.There were no other serious complications.Conclusions The external-route microsurgery is also suitable for rhegmatogenous retinal detachment in vitrectomized eyes which are PVR≤CI and the roles locate in the equator region or front even.This way is simple,convenient and effective.The rate of secondary vitrectomy also can be reduced.
出处
《中国实用眼科杂志》
CSCD
北大核心
2014年第10期1205-1208,共4页
Chinese Journal of Practical Ophthalmology
