超高度近视合并孔源性视网膜脱离手术治疗的临床分析  

Clinical analysis on surgery of super high myopia combined with rhegmatogenous retinal detachment

作　　者：张小娟[1] 曹楠珏 强薇[1] 陈晓隆[1] 

机构地区：[1]中国医科大学附属盛京医院眼科,中国辽宁省沈阳市110004

出　　处：《国际眼科杂志》2016年第11期2150-2153,共4页International Eye Science

摘　　要：目的:回顾分析超高度近视合并孔源性视网膜脱离(rhegmatogenous retinal detachment,RRD)的手术方式、手术效果、术后并发症及处理方法。方法:选择2011-01-01/2016-01-01于我院就诊的超高度近视合并RRD的患者47例47眼,并于我院行巩膜外加压术,玻璃体切除(pars plana vitrectomy,PPV)联合硅油填充术,或玻璃体腔注气术,回顾分析术后6mo内患者的BCVA、眼压、视网膜复位情况、裂孔闭合程度及术后并发症。结果:患者术后6mo时行PPV联合硅油填充的患者视力提高者24眼(71%);单纯行巩膜外加压术的患者视力提高8眼(73%)。统计学检验可见手术治疗能明显改善患者视力,尤其PPV联合硅油填充,但单纯行巩膜外加压术患者视力在本研究中经统计学检验显示无明显意义。PPV联合硅油填充的患者术后高眼压及复视等术后并发症较其他术式更多。结论:超高度近视合并孔源性视网膜脱离的患者需要及时行手术治疗,对术者临床经验及手术要求极高,需要术者根据视网膜裂孔的大小、位置及视网膜脱离范围选择不同的术式,及时恰当处理术后并发症,以争取患者术后裂孔最大程度的闭合、提高视网膜复位率及视功能,提高患者生活质量。AIM： To retrospectively analyze selection of operation, surgery effect, complications and treatment methods of super high myopia combined with rhegmatogenous retinal detachment（ RRD） . METHODS：A total of 47 cases（47 eyes） with the super high myopia patients combined with RRD who accepted scleral buckling of external pressure, vitrectomy combined silicone oil filling, or intravitreous gas injection were chosen in our hospital from Jan. 1, 2011 to Jan. 1, 2016. Best corrected visual acuity （ BCVA）, intraocular pressure, retinal reattached rate, closure rate of holes and the postoperative complications of patients in half year were analyzed. RESULTS：Half a year postoperation, BCVA of twenty-four cases underwent vitrectomy combined silicone oil filling were improving（71%）, and eight cases with scleral buckling surgery were enhanced （ 73%） . Statistical test showed the surgical treatment could significantly improve patients＇eyesight, especially PPV with silicone oil, but the BCVA of patients with scleral buckling of external pressure in this study had no obvious significance according to the rank sum test. Compare with other surgery, pars plana vitrectomy（ PPV ） combined silicone oil filling had more complications, such as high intraocular pressure and diplopia. CONCLUSION： The therapy of super high myopia patients with rhegmatogenous retinal detachment needmany years＇ clinical experience, surgical skill of clinician and according to the number, the shape and the site of the retinal holes and area of detached retina, they need to choose the right means of surgery, and timely deal with postoperative complications, in order to improve the patients＇ postoperative retina, reset rate and visual function.

关 键 词：超高度近视 孔源性视网膜脱离 巩膜外加压术 玻璃体切除术 

分 类 号：R779.6[医药卫生—眼科]