后巩膜加固术治疗高度近视患者黄斑视网膜劈裂的疗效  

Curative effects of posterior scleral reinforce-ment in high myopic patients with macular retinoschisis

作　　者：朱子诚 张金嵩[2] 柯根杰 

机构地区：[1]安徽医科大学附属省立医院眼科,安徽省合肥市230001 [2]郑州大学第一附属医院眼科,河南省郑州市450052

出　　处：《眼科新进展》2009年第6期452-454,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨改良后巩膜加固术治疗高度近视眼黄斑视网膜劈裂的疗效,为临床寻求最佳的治疗方案。方法回顾分析改良后巩膜加固术治疗高度近视眼继发黄斑视网膜劈裂24例(24眼)的术前、术后视野、光学相干断层成像结果、最佳矫正视力、屈光度及眼科A/B型超声检查等指标的改变。结果术后光学相干断层成像显示24眼中视网膜劈裂腔消失20眼;术后12个月仅1眼进展为黄斑裂孔。23眼的眼轴长度均值:术前(30.89±0.36)mm、术后(29.53±0.33)mm,术前术后相比差异有显著统计学意义(t=12.716,P=0.000);中心视野改善者18眼,5眼稳定不变,术前和术后中心视野分别为17.23～26.67dB、23.12～27.63dB,术前术后相比差异有统计学意义(χ2=16.872,P<0.05);视力:术后最佳矫正视力提高2行以上者18眼,稳定5眼;屈光度:23眼术后平均屈光度比术前降低,差异有显著统计学意义(t=3.527,P=0.002)。结论改良后巩膜加固术是目前干预性治疗高度近视眼黄斑视网膜劈裂较理想的方法,可改善视力,预防病情的进一步发展。Objective To investigate the effects of modified posterior sclera reinforcement in high myopic eyes with macular retinoschisis, and to explore the optimal therapeutic prescription. Methods Twenty-four cases（24 eyes） with high myopia and secondary macular retinoschisis were treated with improved posterior scleral reinforcement. Changes of pre- and post-operative visual field, results of optical coherence tomography（OCT） ,best corrected visual acuity（ BCVA）, diopter and ophthalmological A- or B-mode ultrasonography were analyzed. Results OCT showed that macular schizocoel disappeared in 20 eyes, and only 1 eye developed to macular hole at 1 year postoperatively. The average length of axis oculi was （ 30.89 ± 0. 35 ） nun preoperatively and （29.53 ± 0. 33 ）mm postoperatively in 23 eyes （t = 12.716 ,P = 0. 000） ;The central visual field improved in 18 eyes, and remained steadily in 5 eyes. Preoperative and postoperative central visval field were 17.23 dB to 20.57 dB ,23.12 dB to 27.53 dB ,respectively. There was significant difference between them（χ^2 = 16. 872,P 〈 0.05 ）. The postoperative BCVA improved by 2 lines or more was in 18 eyes, and remained steadily in 5 eyes. Postoperative diopter declined in 23 eyes compared with that postoperatively（ t = 3.527, P = 0.002）. Conclusion The improved posterior scleral reinforcement is effective to treat high myopic patients with macular retinoschisis, and can improve visual acuity and prevent the degeneration of disease.

关 键 词：高度近视 继发性黄斑劈裂 后巩膜加固术 

分 类 号：R774.5[医药卫生—眼科]