玻璃体视网膜手术治疗高度近视性黄斑裂孔视网膜脱离  

Treatment of retinal detachment due to macular hole with vitreoretinal surgery in high myopia

作　　者：田农[1] 黄振平[1] 王理理[1] 王毅[1] 

机构地区：[1]南京军区南京总医院眼科,江苏南京210002

出　　处：《医学研究生学报》2005年第5期424-426,F003,共4页Journal of Medical Postgraduates

摘　　要：目的:研究玻璃体视网膜手术对高度近视患者黄斑裂孔性视网膜脱离的治疗效果。方法:病例来源于2000年3月至2004年4月间20例(20只眼)由于高度近视性黄斑裂孔导致的视网膜脱离而住院的患者,其中男3例、女17例,术后随访时间为2～30个月,平均15个月。手术方法采用玻璃体切除联合长效气体或硅油充填术,手术后患者保持低头位至少1周以上。结果:20只眼中,硅油充填5只眼,1次手术后1个月视网膜解剖复位成功率为80%(16/20),4例视网膜脱离复发,其中长效气体充填3只眼,硅油充填1只眼。均未再次手术。术前最佳矫正视力≥0.05为15%(3只眼),随访时的最佳矫正视力≥0.05为55%(11只眼),两者差异有显著性意义(P=0.0386)。术中与术后的主要并发症有:视网膜轻度出血3例(15%);继发性青光眼2例(10%);核性白内障4例(20%),其中3例为硅油充填眼。结论:玻璃体视网膜手术有助于高度近视性黄斑裂孔视网膜脱离的视力恢复。Objective:To investigate the efficacy of Vitreoretinal surgery for retinal detachment due to macular hole in high myopia. Methods:20 cases( 20 eyes) of retinal detachment due to macular hole in high myopia from Dec. 2000 to Apr. 2004 were analysed retrospectively. 3 cases were male and 17 were female, with a following up of 2 to 30 months (15 months in average). The Pars Plana Vitrectomy with long acting gas or silicon oil tamponade were used. The patients were kept face down at least 7 days after the surgery. Results:5 eyes used silicon oil and the others used gas tamponade. The successful rate of retinal reattachment was 80% ( 16/20) with one procedure in a month after the surgery . There were 4 cases of retinal redetachment in the follow-up duration, among them 3 cases used gas and one used silicon oil tamponade. All of them refused to accept another surgery. There were 3 eyes ( 15%) of the best corrected visual acuity greater than or equal to 0.05 before surgery and 11 eyes ( 55%) equal to or greater than 0.05 after the surgery. There was a significant difference between them(P= 0.0386 ). The main complications were slight retinal bleeding in 3 eyes ( 15%); second glaucoma in 2 eyes (10 %); nuclear cataract in 4 eyes ( 20%). Conclusion:Vitreoretinal surgery for retinal detachment with macular hole is available to improve visual acuity in high myopia.

关 键 词：黄斑裂孔 近视 玻璃体视网膜手术 

分 类 号：R774.12[医药卫生—眼科]