巨大裂孔视网膜脱离手术的探讨  

Surgery of retinal detachment with giant retinal tear

作　　者：杨夏[1] 李志敏[1] 王鲜[1] 潘涵英[1] 赵粟[1] 

机构地区：[1]贵阳医学院附属医院眼科,贵州贵阳550004

出　　处：《眼外伤职业眼病杂志》2010年第12期905-907,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的探讨玻璃体视网膜手术治疗巨大裂孔视网膜脱离的手术方法和效果。方法巨大裂孔视网膜脱离11例(11眼)。其中10眼行闭合式三通道玻璃体切除联合巩膜扣带术和眼内视网膜光凝,另1眼未做巩膜扣带。6眼手术中采用全氟化碳液(重水)-硅油置换,硅油眼内填充;5眼为气体-液体交换,硅油填充。结果 11眼手术后视网膜均完全复位。随访观察中视网膜复位良好,2眼已取出硅油。但其中1眼取出油后又发生了视网膜脱离,并出现新裂孔,又做了硅油填充术。2眼发生继发性青光眼,2眼发生了并发性白内障,其中1眼已做了白内障手术。未发生全氟化碳液(重水)眼内残留或角膜变性等并发症。结论玻璃体切除术联合巩膜扣带、硅油眼内填充、视网膜激光光凝能有效治疗有巨大裂孔的视网膜脱离。Objective To disucss and summarize the vitrectomy treatment techniques and outcome on retinal detachment with giant retinal tear. Methods Analyze retrospectively 11 cases（11 eyes）of retinal detchment with giant retinal tear 10 of which were treated by pars plana vitrectomy combined with scleral bucking and intraocular retinal photocoagulation.One case was without scleral bucking surgery.6 cases of which were treated by perfluorocarbon liquid（heavy water）-silicone oil replacement,silicone oil tamponade;5 cases of which were adopted gas-liquid exchange,silicone oil tamponade. Results All the patients got anatomic retinal reattachment.All retinas were showed reattached well in the followed investigations.Silicone oil had been removed in two of them.However,due to a new retinal break,one of them occured retinal detachment after oil removement and silicone oil tamponade was done again.Besides,there were two cases of secondary glaucoma occurred,two cases of complicated cataract occurred in which one of them had under gone the cataract surgery.No complications such as perfluorocarbon liquid（heavy water） intraocular residue or corneal degeneration occurred. Conclusion Vitrectomy treatment combined with scleral buckling,silicone oil tamponade and retinal laser photocoagulation can effectively cure the retinal detachment with giant retinal tear.

关 键 词：视网膜脱离 巨大裂孔 玻璃体切除 

分 类 号：R779.6[医药卫生—眼科]