脉络膜脱离型视网膜脱离外路显微手术的效果  

Curative effect of external-route microsurgery for rhegmatogenous retinal detachment associated with choroidal detachment

作　　者：张海江[1] 许大玲[1] 刘文[2] 霍鸣[1] 

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院眼科,湖北宜昌443003 [2]中山大学中山眼科中心眼科学国家重点实验室

出　　处：《中华眼外伤职业眼病杂志》2013年第5期382-384,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨脉络膜脱离型视网膜脱离外路显微手术的临床效果。方法回顾性病例系列研究，脉络膜脱离型视网膜脱离22例（22眼）。在手术显微镜直视下先预置环扎带，再完成环扎、硅压预置缝线，放视网膜下液或前房穿刺放房水，视网膜冷凝、垫压，核实裂孔、扎紧环扎带和眼内注入膨胀气体，定期观察手术效果。结果术后随访3—12个月。一次手术视网膜复位18例，手术成功率81．82％，其余4例需二次行玻璃体切除术；术后最佳矫正视力≥0．4者3例，0．06—0．3者6例，手动～0．05者13例，与术前相比差异具有统计学意义（X2=6．49，P〈0．05）；无严重并发症发生。结论脉络膜脱离型视网膜脱离外路显微手术具有操作方便、观察直观、并发症少等优点。Objective To evaluate the clinical efficacy of external-route microsurgery for rhegmat- ogenous retinal detachment associated with choroidal detachment. Methods It was a retrospective case se- ries study. 22 cases（22 eyes）with rhegmatogenous retinal detachment associated with choroidal detachment were treated. Under surgical microscope, the encircling and its suture were preplaced, then drainage of sub- retinal fluid or aqueous fluid, retinal cryotherapy, buckling, examination of locating the roles, encircling and intraocular injection of expanding gases were performed. The effects were observed during the follow-up. Re- suits Followed-up ranged from 3 to 12 months. 18 cases （81.82%） achieved retinal reattachment prima- rily, the other 4 cases must be treated by vitrectomy surgery secondly. The final best corrected visual acuity was ≥0.4 in 3 cases ,0.06 - 0.3 in 6 cases and hand motions - 0.05 in 13 cases, which had statistical sig- nificant contrasted to preoperation （X2 = 6.49, P 〈 0.05）. No serious complication occurred. Conclusion The external-route microsurgery is simple, directly observable and with less complications for rhegmatogenous retinal detachment associated with choroidal detachment.

关 键 词：脉络膜脱离 视网膜脱离 裂孔性 显微手术 巩膜加压术 

分 类 号：R779.6[医药卫生—眼科]