巩膜外垫压联合视网膜激光光凝治疗硅油眼视网膜脱离的临床分析  

Treatment for Retinal Detachment in Silicone Oil-filled Eyes by Scleral Buckling and Retinal Laser Coagulation

作　　者：王亮[1] 张红兵[1,2] 王小东[1] 

机构地区：[1]西安市第一医院眼科,西安710002 [2]陕西省眼科研究所

出　　处：《华西医学》2013年第11期1692-1694,共3页West China Medical Journal

摘　　要：目的研究巩膜外垫压手术联合视网膜激光光凝对硅油眼视网膜脱离的治疗效果。方法回顾性分析2009年1月-2012年1月,用巩膜外垫压联合视网膜光凝手术治疗36例硅油眼视网膜脱离的视网膜复位效果。结果全部患者均顺利完成巩膜外垫压手术及随后的视网膜激光光凝,行巩膜外放液5只眼,手术中未发生视网膜嵌顿、眼内出血和眼压显著升高等并发症;手术后1周视网膜复位21只眼(58.33%),剩下15只眼1个月后复位7只眼(19.44%),视网膜脱离总复位率为28只眼(77.77%);未复位8只眼(22.23%),改用玻璃体切割手术方式,视网膜成功复位;6个月后取出硅油,随访6个月视网膜无脱离或者脱离范围增加;手术后眼压≥30 mm Hg(1 mm Hg=0.133 kPa)3只眼,≥20 mm Hg 7只眼,对症治疗1周后眼压均恢复到正常范围。结论巩膜外垫压联合视网膜激光光凝治疗硅油眼视网膜脱离,手术简单,复位率高,可为硅油眼视网膜脱离首选手术方式,对于巩膜外垫压手术失败和复杂的硅油眼视网膜脱离,应当选择玻璃体切割手术方式。Objective To explore the effect of scleral buckling combined with retinal photocoagulation on recurrent retinal detachment in silicone oil-filled eyes. Methods The clinical results of recurrent retinal detachment of silicone oil-filled eyes in 36 patients treated with methods mentioned above from January 2009 to January 2012 were studied retrospectively. Results The operation in 36 patients was completed successfully, and the complications of retinal incarceration, intraocular hemorrhage and marked intraocular pressure （IOP） elevation did not happened during the operation. Retinal reattachment was found in 21 eyes within 1 week （58.33%）, and 7 eyes within 1 month （19.44%）, and total retinal reattachment was 28 eyes （77.77%）. Retinal detachment was found in 8 eyes within 1 month （22.23%）, and which was successfully treated with vitrectomy. Silicone oil was removed after 6 months, and retinal detachment or its aggravation was not found in any one after six months follow-up. High IOP in 10 eyes after operation was controlled accordingly. Conclusion Scleral buckling combined with retinal photocoagulation is simple and its success rate is high in treating recurrent retinal detachment of silicone oil-filled eyes, and it should be regarded as preferred surgical approach, while vitrectomy should be chosen to treat failed cases and complicated ones.

关 键 词：视网膜脱离 硅油眼 巩膜外环扎 眼内激光光凝 

分 类 号：R779.6[医药卫生—眼科]