视网膜脱离高危眼的预防性光凝治疗疗效分析  

The preventive effect of laser photocoagulation for recurred retinal detachment in high-riskeyes

作　　者：但汉东[1,2] 宋秀胜[1,2] 李家璋[1,2] 吴青松[1,2] 李红艳[1,2] 李拓[1,2] 

机构地区：[1]恩施州中心医院 [2]武汉大学恩施临床学院眼科中心,湖北恩施445000

出　　处：《临床眼科杂志》2014年第5期400-402,共3页Journal of Clinical Ophthalmology

摘　　要：目的评估视网膜脱离高危眼变性和裂孔区光凝对发生孔源性视网膜脱离的预防作用。方法2011年1月至2013年9月因高度近视、孔源性视网膜脱离、无晶状体眼、人工晶状体眼在我院眼科就诊的患者,若屈光间质透明可行眼底检查及治疗,则纳入本研究,对高危眼变性区或裂孔区进行激光光凝治疗。每6-12个月随访1次,每次详细记录视网膜病变情况。结果 40例（63只眼）进行了预防性光凝,所有患眼均发生了玻璃体后脱离,其中完全性后脱离28例（39只眼）。31例（46只眼）进行了随访,其中27例（42只眼）痊愈,4例（4只眼）发生了视网膜脱离;最佳矫正视力（BCVA）〈0.05者7只眼,0.05≤BCVA〈0.3者13只眼,0.3≤BCVA〈0.6者20只眼,0.6≤BCVA〈0.8者4只眼,BCVA〉0.8者2只眼。4例（4只眼）视网膜脱离是由于玻璃体后脱离进展和新的视网膜裂孔形成。结论激光光凝治疗可有效预防视网膜脱离高危眼发生孔源性视网膜脱离,但光凝区病变进展和玻璃体后脱离的发展是预防治疗后发生视网膜脱离的主要原因。Objective To investigate the preventive effects of laser photocoagulation in degenerative or hiatal areas forrhegmatogenous retinal detachmentin high-risk eyes. Methods Patientswere recruited from our ophthalmology clinic between January 2011 and September 2013. High-risk eyes are defined as eyes with high myopia,history of rhegmatogenous retinal detachment,and aphakicor pseudoaphakic eyes. A patient with high-risk eyes was enrolled if the media is clear. Laser photocoagulation was conducted at the degenerative or hiatal areas to prevent rhegmatogenous retinal detachment. Subjects were followed every 6 - 12 months. Results We recruitedand treated 40 subjects（63 eyes）. Posterior vitreous detachment presented in all eyes,and in 39 eyes the vitreous detachment was complete. Among the 31 subjects（46 eyes） who completed follow-ups,27 patients（42 eyes） were cured,while retinal detachment recurred in 4 patients（4 eyes）. Best corrected visual acuity was lower than 0. 05 in 7 eyes,between 0. 05 and 0. 3 in 13 eyes,between 0. 6 and 0. 8 in 4 eyes,and higher than 0. 8 in 2 eyes. Recurredretinal detachmentin 4 eyeswas due tonew retinal holes caused byprogressive posterior vitreous detachment. Conclusion Laser photocoagulation can effectively prevent the recurrence of retinal detachment in high-risk patients. Progression of retinopathyat the photocoagulation areasandprogression of posterior vitreous detachment are major causes of recurrence.

关 键 词：视网膜脱离 高危眼 激光光凝 

分 类 号：R779.63[医药卫生—眼科]