三面镜联合显微镜直视下裂孔定位的视网膜脱离手术  

The Retinal detachment operation by retinal holes location under three mirror lens and microscope

作　　者：庄静宜[1,2] 陈焓[1,2] 

机构地区：[1]厦门大学附属第一医院,厦门361003 [2]福建医科大学教学医院

出　　处：《中国实用眼科杂志》2012年第12期1504-1507,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨术前三面镜裂孔定位联合显微镜直视下裂孔定位法在视网膜脱离外路显微手术中运用的临床疗效观察。方法回顾性分析2010—01／2011-05因孔源性视网膜脱离而做视网膜脱离外路显微手术的患者45例45只眼。术前用三面镜检查确定视网膜裂孔位置和距离，作为手术中指导裂孔定位、术中放液和冷冻部位的的依据，放液后在显微镜下更精确的定位冷冻裂孔并360。常规检查周边部视网膜。硅胶局部垫压，随访6～18个月。结果在45例45只眼中，一次手术视网膜完全复位42只眼（93．3％）；矫正视力在0．3以上者31只眼，0．3以下14只眼；最终视力提高40只眼，不变3只眼，下降2只眼；无严重手术并发症；显微镜直视下裂孔定位准确不易遗漏，冷凝反应清晰可见。结论术前三面镜裂孔定位法联合术中显微镜下裂孔定位更准确，操作简单，疗效可靠。Objective Discussing the clinical efficacy of three mirror lens combined with micro- scope in localization of retinal holes in Retinal detachrfient operation. Methods From October2010 to May 2011, retinal detachment （ RD ） 45 patients （45eyes） were enrolled in this study,The loca- tions and distance of retinal holes were estimated by three mirror lens preoperatively as the guide for localization of retinal holes ,drainage of subretinal fluid and freezing in operations. After drain- age, the holes were located more precisely under surgical microscope;360 degree routine examination was performed to observe the retina of denaturation zone; Then, the solid silicone ruberwasp laced under microscope. All the patients were followed up for 6-18 months after surgery. Results In the 45 eyes of 45 cases, 42 eyes are completely reattacbed, visual acuity of 31 eyes were corrected to more than 0.3. The final visualacuity of 40 eyes were improved, while 3 were not changed and the other two were declined. No serious complication was found in 45 cases. Under microscope, the po- sition of retinal holes was accurate and it was not easy to leave out any retina hole. Meanwhile, the reaction of retinal cryotherapy was clearly visible. Conclusion In Retinal detachment operation, three mirror lens combined with microscope was more accurate, simple and effective in the location of retinal holes.

关 键 词：三面镜 显微镜 视网膜脱离 裂孔定位 

分 类 号：R779.6[医药卫生—眼科]