视网膜脱离显微外路手术与传统外路手术的临床比较  

Comparison of scleral buckling surgery for retinal detachment under microscope and under indirect ophthalmoscope

作　　者：杨薇[1] 许惠卓[1] 熊思齐[1] 王祥珪[1] 

机构地区：[1]中南大学湘雅医院眼科,长沙410008

出　　处：《临床眼科杂志》2014年第3期234-236,共3页Journal of Clinical Ophthalmology

摘　　要：目的探讨孔源性视网膜脱离显微外路手术的临床应用特点。方法回顾性分析由同一术者完成的连续的62例孔源性视网膜脱离显微外路手术和连续的35例传统外路手术患者的临床资料,对其进行统计、分析、比较并随访。结果传统外路组和显微外路组患者在基本情况、增生性玻璃体视网膜病变(PVR)分级、视网膜下增生条索、裂孔特点、术中环扎的实施及一次手术成功率方面的差异没有统计学意义;而在术中玻璃体腔注气的实施方面的差异有统计学意义。术中无并发症记载,术后并发症中,两组的高眼压发生率的差异无统计学意义。传统组术后有1例下方视网膜下片状出血,显微组术后有1例出现下方视网膜下出血、1例玻璃体下方积血、1例人工晶状体夹持。结论在以巩膜外加压和冷凝放液作为基本术式的外路手术中,在显微镜直视下完成与在间接检眼镜下完成可以获得同样的手术效果。Objective To explore the effects of microscopic scleral buckling surgeries for rhegmatogenous retinal detachment .Methods We retrospectively analyzed and compared the clinical data of 62 patients with rhegmatogenous ret-inal detachment who received surgeries under microscope to that of 35 patients who received surgeries under indirect oph-thalmoscope by the same operator .Results No statistical difference was found in patients ’ basic information , including PVR grade, presence of subretinal proliferation cords , characteristics of retina hole , the implementation of encircling , and rate of one-time reattachment , between the two groups .There was statistical difference in the implementation of the intravit-real gas injection between the two groups .There was no record of intraoperative complications;postoperatively , the differ-ence in the incidence of high intraocular pressure was not significant between the two groups .Subretinal hemorrhage was found in one patient who underwent the surgery under indirect ophthalmoscope .Comparative number of subretinal hemor-rhage （ n =1）, vitreous hemorrhage （n=1）, and intraocular lens clamping （ n =1） were found in patients who received surgeries under microscope .Conclusion Scleral buckling and cryotherapy for retinal detachment will return similar out-comes when performed under either microscope or indirect ophthalmoscope .

关 键 词：视网膜脱离 巩膜外加压 显微手术 

分 类 号：R779.6[医药卫生—眼科]