干性玻璃体切割在有牵引孔源性视网膜脱离中的应用  

Application of local dry vitrectomy in tractional rhegmatogenous retinal detachment

作　　者：付海涛[1] 孙鼎[1] 宋磊[1] 李智[1] 唐正香[1] 张晶[2] 

机构地区：[1]山东省临沂市人民医院博爱眼科,276003 [2]滨州医学院附属医院眼科,山东省滨州市256603

出　　处：《眼科新进展》2008年第6期444-446,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨视网膜裂孔周围局部干性玻璃体切割联合注气、局部外垫压治疗有牵引孔源性视网膜脱离(rheg-matogenous retinal detachment,RRD)的临床疗效及安全性。方法选择我院有牵引RRD患者40例(40眼),随机分为实验组和对照组,实验组采用双目间接检眼镜直视下冷凝、不放液、巩膜外垫压后,显微镜直视下行单通道孔周局部干性玻璃体切割,切割空间处注C3F8结合体位行内顶压;对照组行常规扣带术。结果术后1个月,实验组视网膜治愈率达100%,对照组治愈率达80%(P<0.001);实验组术后视力均在0.15以上,1例最佳视力达1.0;随访6个月实验组治愈率95%,对照组治愈率60%(P<0.001)。结论对裂孔位于4点和8点水平以上、赤道部周围,尤其瓣缘有明显卷边、瓣周有明显玻璃体牵引的RRD患者,首选孔周局部干性玻璃体切割联合注气和外垫压手术,有利于一次性复位视网膜,最大限度的挽救患者视功能。Objective To observe the clinical effects and safety in the treatment of tractional rhegmatogenous retinal detachment with the therapy of local dry vitrectomy combined with pneumatic retinopexy and scleral buckling. Methods Forty selected cases of tractional rhegmatogenous retinal detachment（ 40 eyes） were divided into two groups at randomly. The experimental group was treated with the therapy of selera freezing combined with selera buckling without drainage, and vitreous traction of tears was removed by local dry vitrectomy under microscope. Pneumatic retinopexy was performed on the room around the tears. Traditional buckling was performed on control group. Results One month after operation the anatomic reattachment rate of the experimental group reached 100%, and control group reached 80% （ P 〈 0.001 ）. Visual acuity of the experimental group was more than 0.15 in all eyes,and the best was 1.0. Following up 6 months, the final anatomic reattachment rate of the experimental group reached 95%, while control group reached 60% （P 〈 0. 001 ）. Conclusion Its effective and safe for RRD patients with slit pore above four o＇ clock and eight o＇ clock and around equater, especially the patients with joggling for flap to use local dry vitrectomy combined with pneumatic retinopexy and sclera buckling to increase visual acuty.

关 键 词：干性玻璃体切割 孔源性视网膜脱离 

分 类 号：R774.12[医药卫生—眼科]