视网膜脱离外路显微手术关键技术应用总结  

Clinical report of the key techniques used in the external-route microsurgery for rhegmatogenous retinal detachment

作　　者：赵春阳[1] 李永雄[1] 李冬莲[1] 黄国舜[1] 

机构地区：[1]中国广东省江门市人民医院眼科,529020

出　　处：《国际眼科杂志》2014年第4期695-697,共3页International Eye Science

摘　　要：目的：总结孔源性视网膜脱离外路显微手术关键技术的临床应用情况。 方法：孔源性视网膜脱离152例，手术显微镜下完成穿刺排液、冷凝、裂孔定位、硅胶垫压等关键技术。 结果：一次手术复位率89．5％，总复位率96．7％；术后1mo，矫正视力＞0．05者89．8％，＞0．3者35．2％；一次穿刺排液成功83．6％，硅胶垫压环扎后需再穿刺排液占13.1％；显微镜下裂孔冷凝定位准确率82．9％，术中调整后准确率90．0％；术中硅胶位置调整占6．6％，需再次手术调整占10．6％；95．4％硅胶垫压后缘位于角膜缘后20 mm以前，4．6％位于20 mm以后。 结论：孔源性视网膜脱离外路显微手术可获得期望的临床效果，其关键技术应用简便、可靠，出现偏差时可适时调整；视网膜可观察范围达角膜缘后20mm，大眼轴高度近视者可达角膜缘后20～24 mm。AIM： To conclude the clinical situation of the key techniques used in the external-route microsurgery for rhegmatogenous retinal detachment. METHODS：A total of 152 patients with rhegmatogenous retinal detachment who underwent drainage of sub -retinal fluids, cryotherapy, localization of the retinal break, silicone scleral buckling by surgical microscope. RESULTS：Retinal reattachment were achieved in 89.5%of patients after the primary surgery and the final reattachment rate was 96.7%, and 89.8% of the eyes achieved the corrected visual acuity high above 0.05, 35.2%above 0.3 at 1mo postoperatively.In 83.6%of eyes had a succeed drainage of sub-retinal fluids by the first acupuncture, and 13.1%of eyes achieved it by the second try after silicone buckling and circling;in 82.9%of cases, the retinal tear localization directly under microscope was accurate, in 90.0% of eyes were achieved it after check and adjustment by the end of operation; in 6.6% of cases, the scleral buckling had to be adjusted to more correct position in the first operation, and 10.6% of eyes had to be adjusted in the next operation; in 95.4% of eyes, the posterior edge of silicone buckling were within 20mm behind corneal limbus, 4.6%of eyes were behind 20mm. CONCLUSION： The external-route microsurgery can bring us expected clinical results for rhegmatogenous retinal detachment.Its key microsurgical techniques are applied in convenient, reliable, and can be adjusted timely when some deviations occurred.The observable retina under microscope range from ora serrata to 20mm behind corneal limbus, and even to 20-24mm in some high myopia eye with large axial length.

关 键 词：孔源性视网膜脱离 外路显微手术 

分 类 号：R779.6[医药卫生—眼科]