高度近视黄斑裂孔性视网膜脱离玻璃体手术56例  

Vitrectomy for retinal detachment of high myopia macular hole in 56 cases

作　　者：肖云[1] 高晓唯[1] 蔡雪虹[1] 赵勇[1] 

机构地区：[1]解放军474医院眼科全军眼科中心

出　　处：《国际眼科杂志》2005年第1期121-122,共2页International Eye Science

摘　　要：目的:评价高度近视黄斑裂孔性视网膜脱离玻璃体手术治疗效果。方法:高度近视黄斑裂孔性视网膜脱离患者56例,行玻璃体切除。PVRC1者10眼,C2者14眼,C3者32眼,伴周边部裂孔7眼,白孔11眼。手术中彻底清除玻璃体后皮质,或人工玻璃体后脱离剥膜,气液交换使视网膜复位,眼内填充200mL/LC3F845眼,白孔者眼内硅油填充。并发周边部裂孔病例后行巩膜外环扎裂孔冷凝。术后给予抗炎降眼压处理。气泡变小裂孔愈合不佳,裂孔周围氪黄激光封闭或再次补充气体。注气者俯卧位14d以上。所有患者随访3～12mo。结果:黄斑裂孔闭合、视网膜复位53例,周边裂孔闭合7例。术后视力提高46眼(82.1%),黄斑裂孔术后视力无变化10眼。结论:玻璃体切除联合眼内填充C3F8或硅油治疗高度近视黄斑裂孔性视网膜脱离是安全有效的。AIM: To evaluate the effects of vitrectomy on retinal detachment of high myopia macular hole.· METHODS: A total of 56 patients with retinal detachment of high myopia and macular hole underwent vitrectomy. There were 10 eyes of PVRc1, 14 eyes of PVRc2 and 32 eyes of PVRc3, including 7 eyes of retinal peripheral hole and 11 eyes of white hole. During the surgery, full vitreous cortex cleanout or membrane peel-off after man-made posterior vitreous detachment was performed, then air-fluid exchange was done to cause retinal replacement. The 11 eyes of white hole were filled with silicone oil and the other 45 eyes with 20% C3F8. Moreover, scleral encircling and cryotherapy were done to the cases with retinal peripheral hole, and anti-inflammation therapy was used to reduce the intraocular pressure after surgery. For patients whose bleb became smaller and the concrescence was not good, krypton laser was shot around the hole or gas was reinforced. All patients got gas fill were kept lying face down for at least 14d. The follow-up ranged from 3 to 12mo.· RESULTS: Macular hole and retinal hole in 53 cases and retinal periphral hole in 7 cases were closed. Postoperative visual acuities of 46 eyes (82.14%) were improved, and those of the other 10 eyes of high myopia macular hole did not change after surgery.· CONCLUSION: The therapy of vitrectomy combined with C3F8 or silicon oil fill is safe and available to cure retinal detachment of high myopia and macular hole.·

关 键 词：黄斑裂孔性视网膜脱离 高度近视 玻璃体手术 眼内 C3F8 视网膜复位 术后视力 结论 补充 目的 

分 类 号：R779.6[医药卫生—眼科]