玻璃体视网膜手术治疗复杂性外伤性视网膜脱离的长期临床观察  

Long-term clinical observation of complex traumatic retinal detachment treated with Vitreoretinal surgery

作　　者：于华香[1] 陈松[1] 张珑俐[1] 赵秉水[1] 李燕[1] 

机构地区：[1]天津医科大学眼科临床学院、天津市眼科医院、天津市眼科研究所,天津 300020

出　　处：《中国实用眼科杂志》2008年第12期1361-1364,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察玻璃体视网膜手术（vitreoretinal surgery，VRS）治疗复杂性外伤性视网膜脱离（retinal detachment，RD）的长期临床效果。方法回顾性分析1999年3月至2006年12月收治的复杂性外伤性RD患者97例98只眼，行VRS联合过氟化碳液体、视网膜切开和硅油填充术等，观察术后随访视力，解剖复位等情况。结果术后随诊8．5～84个月（平均23．5个月），末次随诊时3只眼失访，74只眼术后视力均有不同程度提高（75．51％）。术前与末次随诊视力比较，差异有统计学意义（χ^2=25．51，P〈0．05）.末次随访时视力恢复至0．1及以上23只眼（23．47％），92只眼（93．88％）解剖复位，其中71只眼（72．45％）1次VRS手术后痊愈，21只眼在VRS后因出现视网膜前膜、复发RD或裂孔。于术后6～14周分别再次行VRS、巩膜扣带术（scleral bucklingsurgery，SBS）联合激光等2～4次手术。硅油取出60只眼，取油时间0．5--11个月，平均5．11个月。结论VRS手术对外伤眼的解剖重建及功能恢复起着重要作用。通过长期的临床观察，视力稳定或提高，视网膜复位较好。Objective To observe the long-term clinical outcomes of complicated traumatic retinal detachment treated with vitreoretinal surgery. Method Between March 1999 and December 2006, consecutive cases of 98 eyes （97 patients）with complicated traumatic retinal detachment had undergone VRS with perfluorocarbon liquid,retinal section and silicone oil etc,postoperative visual acutiy ,anatomic success and others were retrospectively observed.Results The follow-up 8.5 to 84 months, at the end, 3 eyes were not follow-up. Visual acutiy improved in 74 eyes （75.51% ）, final visual acutiy was better than preoperative （χ^2=25.51 P 〈 0.05 ）, 23 eyes were more than 0.1.92 eyes（93.88 % ）were attached 1 successfully, 71 eyes（72.45 % ）were cured after primary VRS, during 6 to 14 weeks postoperative, 21 eyes had undergone VRS 、 SBS and the laser for two to four times respectively due to retinal membranes, the recurrence RD or a hole, 60 eyes had silicone oil removed, 0.5-11 month （average 5.11 ）postoperative.Conclusion VRS can rebuild eye ball, make retinal reattached,and improve visual acutiy.

关 键 词：玻璃体视网膜手术 眼外伤 视网膜脱离 

分 类 号：R774.12[医药卫生—眼科] R779.6[医药卫生—临床医学]