伴有前瓣牵引的多发裂孔性视网膜脱离的玻璃体切割术与单纯巩膜扣带术的临床疗效分析  

Curative effects of vitreoctomy and scleral buckling on retinal multiple-tear detachment associated with tracted anterior flap

作　　者：赵秉水[1] 张斌[1] 赵芳[1] 陈松[1] 李燕[1] 

机构地区：[1]天津市眼科医院,天津市眼科研究所,300040

出　　处：《中华眼底病杂志》2004年第4期209-211,共3页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的　探讨伴有前瓣牵引的多发裂孔性视网膜脱离的手术方法及疗效。　方法　回顾分析1999年 1月～ 2 0 0 2年 1月收治的 89例伴有前瓣牵引的多发裂孔性视网膜脱离患者 89只眼的临床资料 ,其中 4 1只眼行玻璃体切割手术 ,4 8只眼行单纯巩膜扣带手术。比较两组患者手术后随访 2～ 36个月 ,平均随访 (11.0 2± 7.90 )个月时的视力、视网膜复位率和手术后并发症。　结果　玻璃体切割手术组 4 1只眼中 ,最终手术成功 38只眼 ,占 92 .7%。视力提高 33只眼 ,占 80 .5 % ;不变 6只眼 ,占 14 .6 % ;下降 2只眼 ,占4 .9%。手术后并发症中前房絮状膜样渗出 2只眼 ,占 4 .9% ;并发性白内障 3只眼 ,占 7.3% ;严重增生性玻璃体视网膜病变 (PVR) 3只眼 ,占 7.3%。单纯巩膜扣带手术组 4 8只眼中 ,最终手术成功 4 1只眼 ,占85 .4 %。视力提高 36只眼 ,占 75 .0 % ;不变 4只眼 ,占 8.3% ;下降 8只眼 ,占 16 .7%。手术后并发症中前房絮状膜样渗出 6只眼 ,占 12 .5 % ;并发性白内障 9只眼 ,占 18.8% ;严重 PVR8只眼 ,占 16 .7%。　结论　伴有前瓣牵引的多发裂孔性视网膜脱离的玻璃体切割手术和单纯巩膜扣带手术 ,手术成功率无差异。玻璃体切割手术组手术后视力提高优于单纯巩膜扣带手术组 。Objective To evaluate the curative effects of vitreoctomy or simple scleral buckling on retinal multiple-tear detachment associated with tracted anterior flap. Methods The clinical data of 89 eyes in 89 patients with retinal multiple-tear detachment associated with tracted anterior flap diagnosed in Jan, 1999-Jan, 2002 were retrospectively analyzed. In the 89 patients, 41 had undergone vitreoctomy and 48 had undergone scleral buckling without vitrectomy. In the duration of 2- to 36-month follow-up with the mean of (11.02±7.90) months, visual acuity, retinal reattached rate and postoperative complication were examined and the results in the 2 groups were compared. Results In 41 eyes underwent vitreocotmy, successful reattachment was found in 38 (92.7%); visual acuity increased in 33 (80.5%), didn′t change in 6 (14.6%), and decreased in 2 (4.9%); leakage of flocculent membrane in anterior chamber occured was found in 2 (4.9%), complicated cataract in 3 (7.3%), and severe proliferative vitreoretinopathy (PVR) in 3 (7.3%). In 48 eyes underwent scleral buckling, 41 (85.4%) had success reattachment; visual acuity increased in 36 (75.0%), didn′t change in 4 (8.3%), and decreased in 8 (16.7%); leakage of flocculent membrane in anterior chamber was found in 6 (12.5%), complicated cataract in 9 (18.8%), and severe PVR in 8 (16.7%). Conclusion There isn′t any difference of the success rate of the surgery between vitrectomy and scleral buckling for retinal multiple-tear detachment associated with tracted anterior flap. The better visual acuity and less complications are found in the vitrectomy group than those in the scleral buckling group.

关 键 词：前瓣牵引 多发裂孔性视网膜脱离 玻璃体切割术 单纯巩膜扣带术 术后并发症 

分 类 号：R779.6[医药卫生—眼科]