儿童裂孔性视网膜脱离的临床特点及手术治疗  

Clinical characters and surgery of children's rhegmatogeneous retinal detachment

作　　者：肖云[1] 高晓唯[1] 蔡雪虹[1] 赵勇[1] 顾晓宇[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179-180,共2页International Eye Science

摘　　要：目的:评价儿童裂孔性视网膜脱离的临床特点、手术方法及疗效。方法:对10例11眼,年龄10～15(平均13.0)岁。男8例,女2例。除2例2眼1a前有拳击外伤史,余均无明显外伤史。术前视力光感～0.04者4眼,0.05～0.3者6眼,≥0.3者1眼,高度近视5例,正视眼和低度近视5例。裂孔形态:7眼为圆孔,1眼马蹄孔合并圆孔,1眼为视网膜巨大裂孔,2眼锯齿缘截离孔。除2例2眼有部分玻璃体后脱离外,其余都没有玻璃体后脱离。PVR分级A级4眼,B级4眼,C1级2眼,C2级1眼。其中10眼行巩膜外环扎外加压术,巨大裂孔眼行玻璃体手术硅油填充。结果:9眼1次获得视网膜复位,1眼因出现新裂孔导致视网膜复位不良,再次外加压注气封闭裂孔治愈。随诊3mo,全部病例视网膜复位良好。视力提高,最好的1眼视力达0.5。硅油眼6mo后取出硅油,视网膜复位良好。结论:环扎加压术在儿童玻璃体后脱离极少的情况下为孔源性视网膜脱离的首选术式。AIM: To evaluate the effects, clinical characters and surgery of children's rhegmatogeneous retinal detachment.· METHODS: Ten children (11 eyes) with rhegmatogeneous retinal detachment were selected, including 8 males and 2 females. Their ages ranged from 10 to 15 years old with the mean of 13.0 years old. They had no trauma except 2 eyes of 2 children, resulting from boxing wound 1a before. The preoperative visual acuities were: light perceive-0.04 in 4 eyes, 0.05-0.3 in 6 eyes and higher than 0.3 in 1 eyes. Five cases had high myopia and the other 5 cases had emmetropia or low myopia. The tear configuration was rotundity in 7 cases, rotundity together with horseshoe retinal tear in 1 case, giant tear in 1 case and dialysis of ora serrata in the other 2 cases. Most cases had no posterior vitreous detachment except for 2 who had partial posterior vitreous detachment. Four eyes were PVR grade A, 4 eyes PVR grade B, 2 eyes PVR grade C1 and 1 eye PVR grade C2. Ten eyes underwent scleral encircling, and the 1 eye with giant tear was treated with vitrectomy and silicone oil fill.· RESULTS: Nine eyes got one-off retinal replacement. Bad retinal replacement was found in 1 eye because of newly-appeared hole, and was cured by refilling gas to close the tear. All patients got well during the follow-up of 3mo, and the best vision was 0.5. The silicone oil filled to the eyes was taken out 6mo later.CONCLUSION: Scleral encircling is a prefered surgery to treat children's rhegmatogenous retinal detachment in cases of little posterior vitreous detachment.·

关 键 词：裂孔性视网膜脱离 玻璃体后脱离 视网膜复位 临床特点 巨大 外伤史 儿童 拳击 结论 合并 

分 类 号：R779.6[医药卫生—眼科]