高度近视眼黄斑裂孔性视网膜脱离手术的临床观察  

Clinical Efficiency of Operative Treatment for Retinal Detachment Caused by Macuiar Hole in High Myopia

作　　者：刘豫[1,2] 郭小健[1] 朱晓华[1] 唐罗生[1] 

机构地区：[1]中南大学湘雅二医院眼科,长沙410011 [2]中南大学湘雅三医院眼科,410013

出　　处：《中国眼耳鼻喉科杂志》2005年第1期42-44,共3页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨高度近视眼黄斑裂孔性视网膜脱离手术治疗的临床疗效。方法回顾性分析高度近视眼黄斑裂孔性视网膜脱离患者86例98眼,行4种不同手术方式的疗效,手术后随诊6～12个月,以视网膜复位情况、最佳矫正视力、术后并发症作为疗效观察的指标。结果 1.单纯玻璃体腔注气术:视网膜复位率63.33%.视力改善率50.00%,并发症发生率16.67%。2.巩膜环扎和(或)外加压联合注气术:视网膜复位率76.88%,视力改善率75.00%,并发症发生率28.13%。3.玻璃体切割联合剥膜注气术:视网膜复位率80.00%,视力改善率60.00%,并发症发生率55.00%。4.玻璃体切割联合剥膜硅油充填术:视网膜复位率87.50%,视力改善率37.50%,并发症发生率87.50%。结论根据 PVR(proliferative vitreoretinopathy)程度、黄斑前膜、视网膜脱离范围等合理选择术式,均能达到较好的解剖复位及功能改善。Purpose To evaluate the difference of curative effects of different surgical treatments for high myopic eyes with retinal detachment (RD) and macalar hole (MH).Methods A retrospective analysis was made for clinical efficiency of 98eyes with RD of 86 cases resulting from high myopic MH treated with four modes of operation,The follow-up period was 6～12 months.The main distingaishable indexes measures include the anatomic reattachment rate,the change of the best corrected visual acuity (BCVA) and the postoperative complication rate.Results 1.Single vitreous cavity gas injection operation:anatomic reattachment rate 63.33%,the BCVA improvement rate 50.00%,and postoperative complication rate 16.67%;2.Poserior episcleral buckle pracedure (PEBP) and (or) scleral buckling with gas injection operation:anatomic reattachment rate 76.88%,the BCVA improvement rate 75.00% and postoperative complication rate 28.13%;3.PPV with membrane removal and gas injection operation:anatomic reattachment rate 80.00%,the BCVA improvement rate 60.00% and postoperative complication rate 55.00%;4.PPV with membrane removal and silicone oil tamponade operation:anatomic reattachhment rate 87.50%,the BCVA improvement rate 37.50%,and postoperative complication rate 87.50%.Conclusion For high myopic eyes with RD and MH,to achieve better anatomic reattachment rate and BCVA improvement rate,surgical manipulations should be chosen based on the macular membrane condition,the degree of PVR and the area of retinal detachment.

关 键 词：视网膜复位 并发症发生率 高度近视眼 黄斑裂孔性视网膜脱离 视力 注气术 联合 玻璃体切割 剥膜 手术 

分 类 号：R779.6[医药卫生—眼科]