手持式全视网膜镜下25G玻璃体手术治疗先天性小角膜合并脉络膜缺损视网膜脱离  

25 Gauge vitreous surgery assisted by hand-held panretinoscope on congenital microcornea complicated with choroidal coloboma and retinal detachment

作　　者：梁军 张伟 杨艳 LIANG Jun ZHANG Wei YANG YaTa(Beijing A ier-lntech Eye Hospital, Beijing 100021, China)

机构地区：[1]北京爱尔英智眼科医院,北京100021

出　　处：《中国中医眼科杂志》2016年第4期254-256,共3页China Journal of Chinese Ophthalmology

摘　　要：目的观察手持式全视网膜镜下25G治疗先天性小角膜合并脉络膜缺损视网膜脱离的临床疗效。方法回顾性分析先天性小角膜合并脉络膜缺损视网膜脱离患者13例（13只眼），均行手持式全视网膜镜下睫状体平坦部角膜缘4．0mm三切口闭合式25G玻璃体切割术。术前术后观察视力变化、视网膜复位及复发情况。结果所有病例随访6—24个月，平均12个月。13只眼中，1次手术视网膜复位成功12只眼，占92-3％。1只眼于术后6个月因颞上周边视网膜增殖牵引再次发生视网膜脱离。行再次玻切术后视网膜复位。患眼术后视力均不同程度提高，脉络膜缺损累及视盘的4例患者术后视力提高至数指。脉络膜缺损位于视盘下方者9例．其中2例患者术后矫正视力为0．1以上，余7例患者术后矫正视力均在0．02～0．1。结论先天性小角膜合并脉络膜缺损视网膜脱离行玻切视网膜复位手术由于受到小角膜小瞳孔的影响，手术视野小，难度大，利用手持式全视网膜镜全视野与25G切口及切割效率的优势可以较好地完成手术，手术安全性好，成功率高，有一定的临床应用价值。OBJECTIVE To observe the treatment effects of 25 Gauge （25G） vitreous surgery assisted by handheld panretinoscope on congenital microcornea complicated with choroidal coloboma and retinal detachment. METHODS This study consisted of a retrospective analysis of congenital microcornea complicated with choroidal coloboma and retinal detachment in 13 eyes of 13 patients. All patients underwent 25G pars plana three incision （4.0ram after limbus） closed vitrectomy. Preoperative and postoperative visual acuity, condition of retinal reattachment and recurrence were observed. RESULTS All patients were followed up for 6-24 months and 12 months in average. Among 13 eyes, retinal reattachments were successfully performed in 12 eyes, accounting for 92.3%. Retinal detachment occurred again in 1 eye 6 months after vitrectomy due to the superior temporal peripheral retinal proliferation. Postoperative visual acuity improved in different levels. The postoperative visual acuity improved to finger count in 4 eyes with choroidal coloboma area involved the optic disc. Among 9 eyes that had choroidal coloboma located below of the optic disc, 2 cases experienced postoperative corrected visual acuity of more than 0.1, the other 7 cases got postoperative corrected visual acuity in 0.02 -0.1. CONCLUSIONS Vitrectomy for congenital mierocornea complicated with choroid coloboma and retinal detachment was affected by the small corneal and pupil which made operation more difficult due to the small field of view. The use of 25G incision vitrectomy assisted by hand-held panretinoseope with full field view could better support operation and improve operation safety and efficiency.

关 键 词：手持式全视网膜镜 25G 小角膜 脉络膜缺损视网膜脱离 

分 类 号：R774.12[医药卫生—眼科]