23 G微创玻璃体手术联合吊顶灯照明系统治疗复杂性外伤性视网膜脱离  

23-gauge micro-invasive vitrectomy combined with chandelier illumination for traumatic retinal detachment

作　　者：张来霞[1] 郝风芹[2] 李聪伶[1] 王清秀[1] 范东霞[1] 

机构地区：[1]潍坊医学院附属医院眼科中心,山东省潍坊市261031 [2]潍坊医学院,山东省潍坊市261031

出　　处：《眼科新进展》2016年第1期78-80,共3页Recent Advances in Ophthalmology

摘　　要：目的观察23 G玻璃体切割手术联合吊顶灯治疗复杂性外伤性视网膜脱离的临床疗效及并发症情况。方法回顾性分析2012年6月至2013年12月在我院眼科中心住院的50例（50眼）复杂性外伤性视网膜脱离患者,行吊顶灯辅助下23 G玻璃体切割手术,随访2~6个月,平均3.6个月,观察所有患者术前和术后不同时间点最佳矫正视力、眼压变化情况,分析术中、术后并发症,分析视网膜解剖复位率等情况。结果术中无医源性裂孔、出血等并发症发生,术后无脉络膜脱离、眼内炎等并发症发生。10眼（20.0%）出现术后高眼压,经治疗后均恢复正常。术毕拔除套管后巩膜切口渗漏需缝合者15眼（30.0%）。最终视网膜全部复位。术后1周及1个月、3个月测得的平均眼压与术前相比差异均无统计学意义（均为P〉0.05）。术后1个月、3个月最佳矫正视力均较术前提高,差异均有统计学意义（均为P〈0.05）。结论 23 G玻璃体切割术具有微创、手术时间短等优点,联合吊顶灯治疗复杂性外伤性视网膜脱离是一种安全有效的手术方法。Objective To observe the clinical effects of 23-gauge micro-invasive vitrectomy combined with chandelier illumination in the treatment of traumatic retinal detachment and its complications.Methods In a retrospective case series study,the 23-gauge micro-invasive vitrectomy combined with chandelier illumination were done in 50 patients（50 eyes） with traumatic retinal detachment in our hospital from June 2012 to December 2013.For all cases,the 23-G vitrectomy system combined with 25-G chandelier illumination were used.Postoperative follow-up ranged from 2 months to 6 months（mean 3.6 months）.The best corrected visual acuity were also recorded before and 1 month after surgery.Main outcome measures included complications from the operation,retinal anatomical status,and intraocular pressure.Results No iatrogenic retinal breaks or hemorrhage occurred during the operations.No choroidal detachment,hyphema,effusion or endophthalmitis occurred after operation.Early ocular hypertension in 10 eyes（20%）was controlled by treatment.Intraoperative suture placement was required for leaking sclerotomies in 15 cases（30%）.The final retinal reattachment rate was 100%.There was no statistical difference in intraocular pressure between pre-operation and 7 days,1 month after surgery in each group（all P〉0.05）.There was statistical difference in best visual acuity between before surgery and 1 month,3months after surgery（all P〈0.05）.Conclusion 23-gauge micro-invasive vitrectomy combined with 25-G chandelier illumination is a safe and effective therapeutic method to treat traumatic retinal detachment with short time.

关 键 词：23 G玻璃体切割系统 吊顶灯 外伤性视网膜脱离 

分 类 号：R774.12[医药卫生—眼科]