多裂孔性视网膜脱离患者视功能的恢复:两种手术方法作用比较(英文)  

Visual function recovery from retinal detachment with multiple tears:comparison between vitrectomy and scleral buckling

作　　者：孙大卫[1] 彭绍民[1] 谢芳[2] 王绍伟[1] 

机构地区：[1]哈尔滨医科大学附属第二医院眼科,黑龙江省哈尔滨市150086 [2]哈尔滨医科大学附属附属第一医院眼科,黑龙江省哈尔滨市150001

出　　处：《中国临床康复》2004年第35期8107-8109,共3页Chinese Journal of Clinical Rehabilitation

基　　金：黑龙江省教育厅科技基金(10541141)~~

摘　　要：背景:多裂孔性视网膜脱离是一种复杂的高致盲性眼病,传统的的环扎加压手术和新近开展的玻璃体切除术在视网膜脱离治疗中的作用是不同的,而在患者术后视功能的恢复上尤其值得关注。目的:比较分析多发裂孔性视网膜脱离患者行玻璃体切除术与环扎加压术的术后视功能恢复效果。设计:前后对照研究。单位:哈尔滨医科大学附属第二医院及附属第一医院眼科。对象:1999-10/2003-09在哈尔滨医科大学附属第二医院住院手术治疗的多裂孔性视网膜脱离患者,共173例173眼。方法:回顾性分析。比较同一时期多裂孔性视网膜脱离患者玻璃体切除术组(79眼)与环扎加压术组(94眼)的一次手术成功率、最终手术总成功率、术后视功能恢复情况及并发症的发生率。主要观察指标:①两组患者手术成功率及视功能恢复情况。②两组患者并发症的发生率。结果:玻璃体切除术组一次手术成功率92%,显著高于环扎加压术组81%(P<0.05),术后视力提高者玻璃体切除术组54眼占68%,环扎加压术组50眼占53%,差异有显著性意义(P<0.05)。最终手术成功率和并发症的发生率两组间差异无显著性意义(P>0.05)。结论:对多裂孔性视网膜脱离的治疗,在选择好适应证的前提下,玻璃体切除术在一次手术成功率和术后视功能的恢复方面都优于环扎加压术。BACKGROUND:Retinal detachment with multiple tears is a complicated disease with high risk of blindness.Conventional scleral buckling and the much more recent vitrectomy differ in their effects for correcting retinal detachment,and the subsequent visual function recovery following the two surgeries needs thorough examination. OBJECTIVE:To compare conventional scleral buckling and vitrectomy for postoperative visual function recovery in the treatment of retinal detachment with multiple tears. DESIGN:A self-controlled clinical observation SETTING:Department of Ophthalmology,First and second Affiliated Hospitals of Harbin Medical University. PARTICIPANTS:A total of 173 eyes from 173 patients with retinal detachment with multiple tears were surgically treated in the Department of Ophthalmology between October 1999 and September 2003. METHODS:A retrospective analysis was performed for comparison of the single operation success rate,final operation success rate,improvement of visual function and incidence of complications between conventional buckling surgery(94 eyes) and vitrectomy(79 eyes). MAIN OUTCOME MEASURES:The operation success rate, improvement of visual function,and the incidence of complications in the two groups receiving different surgeries. RESULTS:The single operation success rate was significantly higher in vitrectomy group than in the buckling group(92%vs 81%,P< 0.05).Vitrectomy resulted in visual function improvement in 54 eyes(68%),and buckling surgery in 50 eyes (53%,P< 0.05).The final success rate and incidence of complications were similar between the two groups(P >0.05). CONCLUSION:Vitrectomy is a better option than buckling in treating retinal detachment with multiple tears concerning one-time operation success rate and visual improvement, provided the indications are properly defined.

关 键 词：玻璃体切除术 视网膜脱离 功能恢复 

分 类 号：R774.1[医药卫生—眼科]