微创玻璃体切割手术治疗脉络膜脱离型视网膜脱离临床疗效观察  

The efficacy of micro-invasive vitrectomy for retinal detachment associated with choroidai detachment

作　　者：刘文[1] 张少波[2] 柯治生[1] 许金玲[1] 任增金[1] 孙吉君[1] 李聪慧[1] 宋宗明[1] 

机构地区：[1]温州医学院附属眼视光医院,325027 [2]第四军医大学唐都医院眼科

出　　处：《中华眼底病杂志》2012年第6期593-597,共5页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察微创玻璃体切割手术治疗脉络膜脱离型视网膜脱离的临床疗效及安全性。方法临床检查确诊的脉络膜脱离型视网膜脱离患者35例36只眼纳入研究。其中，男性22例，女性13例。平均年龄（51．32土17．34）岁。视力光感6只眼；手动／眼前者12只眼；数指者9只眼；o．01～O．1者8只眼；o．2～O．3者1只眼。平均最小分辨角对数（LogMAR）视力为2．13±0．50。平均眼压为（9．17±6．28）mmHg（1mmHg=0．133kPa）。患者均行23G联合25G经结膜无缝合玻璃体手术。手术中硅油填充35只眼，C。F8填充1只眼。手术后平均随访时间（6．23±3．07）个月。对比观察手术前后视力、眼压变化情况，以及手术后视网膜复位率、视网膜脱离再发生率及并发症等情况。结果手术后1d，所有患眼视网膜均复位，占100．0％；手术后1个月，视网膜复位33只眼，占91．7％；视网膜局限性脱离3只眼，占8．3％，再次行巩膜扣带手术，视网膜复位。手术后3个月，视网膜复位30只眼，占83．3％。手术后1d，1、3个月平均LogMAR视力分别为1．77±0．66、1．53土0．72、1．31土0．77，与手术前平均LogMAR视力比较，差异有统计学意义（F=62．61，P〈O．05）。手术后1d，1、3个月眼压分别为（12．47±7．28）、（15．51±6．86）、（15．82士7．60）mmHg（1mmHg：0．133kPa）。手术后各时间点平均眼压与手术前平均眼压比较，差异均有统计学意义（F=6．88，P〈0．05）。手术后3个月，发生继发性青光眼1只眼；此外无与治疗相关的其他并发症。结论微创玻璃体手术治疗脉络膜脱离型视网膜脱离有良好的临床疗效。Objective To observe the efficacy and safety of micro-invasive vitrectomy for retinal detachment associated with choroidal detachment. Methods A total of 35 patients （36 eyes） with retinal detachment associated with choroidal detachment were enrolled in this study. The patients included 22 males and 13 females, with a mean age of （51.32 ±17.34） years. Visual acuity was light perception in six eyes, hand movement in 12 eyes, finger counting in nine eyes, 0.01 - 0.1 in eight eyes, and 0.2 - 0.3 in one eye. The median LogMAR visual acuity was （2.13±0.50）. The median intraocular pressure was （7.08±2.62） mm Hg （1 mm Hg=0. 133 kPa）. All the patients were received vitrectomy using 23-gauge instrumentation combined with 25-gauge infusion. Tamponade with silicone oil （35 eyes） or C3F8 gas （one eye） were performed. The median follow-up time was （6.23 ±3.07） months. The pre-and post-operative visual acuity, intraocular pressure, the rate of retinal reattachment, the rate of recurrent retinal detachment and complications were comparatively analyzed. Results Retinal reattachment was attained in 36 eyes （100%） at the first day after vitrectomy. Retinal reattachment was attained in 33 eyes （91.7 %） and recurrent retinal local detachment was attained in three eyes （8.3%） at one months after vitrectomy. The rate of retinal reattachment was 83.3% （30 eyes） at three months after vitrectomy. One day, one and three months after treatment, the mean LogMAR visual acuity were 1.77±0.66, 1.53±0.72, 1.31±0.77 respectively. The differences of the visual acuity was statistically significant between before and after vitrectomy （F= 62.61, P〈0.05）. One day, one and three months after treatment, the mean intraocular pressure were （12.47±7.28）, （15.51± 6.86）, （15.82 ± 7.60） mm Hg respectively. The differences of the intraocular pressure was statistically significant between before and after vitrectomy （F= 6.88, P〈0.05）. Secondary glaucomaoccurred in oueeyeat three

关 键 词：视网膜脱离 外科学 玻璃体切除术 治疗结果 

分 类 号：R779.6[医药卫生—眼科]