后巩膜加固术治疗高度近视后巩膜葡萄肿的效果  

The efficiency of post-sclera reinforcement surgery for the treatment of high myopia with posterior scleral staphyloma

作　　者：陈梦平[1] 唐文建[1] 沈策英 何利[1] 

机构地区：[1]郑州市第二人民医院眼科郑州市眼科医院450006

出　　处：《中华眼外伤职业眼病杂志》2016年第11期841-845,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：郑州市普通科技攻关计项目资助（121PPTGG495-3）

摘　　要：目的：评价后巩膜加固术治疗高度近视后巩膜葡萄肿的安全性和效果。方法回顾性分析高度近视后巩膜葡萄肿64例（107只眼）的住院病历资料。所有患者均行后巩膜加固术,部分联合前房穿刺术,随访6-18个月,观察其安全性及疗效。结果所有病例均顺利完成手术。术前最佳矫正视力（logMAR）、眼轴、屈光度分别为：（0.51±0.43）,（29.57±2.63）mm,（-16.63±3.07） D,分别与术后2周：（0.37±0.31）,（28.03±2.13）mm,（-14.35±2.33） D相比差异均有统计学意义（P〈0.05）。术后6个月分别为（0.27±0.23）,（28.11±2.16） mm,（-14.62±2.89）D,与术前相比差异均有统计学意义（P〈0.05）。术后6个月和术后2周的BCVA、眼轴、屈光度的比较,差异均无统计学意义（P〉0.05）。术中并发症涡静脉损伤1眼（0.9%）；术后并发症视网膜出血和眼眶无菌性炎症反应各1眼（0.9%）,未出现感染、视网膜脱离或缺血性视神经病变等严重并发症。结论后巩膜加固术是治疗高度近视后巩膜葡萄肿的安全有效的方法。能有效控制眼轴和屈光度的增长,稳定或提高视力。Objective To evaluate the safety and clinical efficacy of post-sclera reinforcement for the high myopia with posterior scleral staphyloma. Methods The data of 107 eyes of 64 cases of high myopia with posterior scleral staphyloma were retrospectively analyzed. All the cases underwent post-sclera reinforcement. Some of them received the combined procedure of anterior chamber paracentesis. And followed up for 6 to 18 months, the best corrected vision （BCVA）,axial length and diopter were observed. Results All the operations were successful. Before surgery, the BCVA（log MAR）, axis length and diopter were 0. 51 ± 0. 43, （29. 57 ± 2. 63）mm and（ -16. 63 ± 3. 07） D . At 2 weeks after the operation, they were 0. 37 ± 0. 31, （28. 03 ± 2. 13）mm and （ -14. 35 ± 2. 33） D. At 6 months after the operation, they were 0. 27 ± 0. 23, （28. 11 ± 2. 16） mm and （ -14. 62 ± 2. 89） D. The differences of these three items between preoperation and 2 weeks after operation, preoperation and 6 months after operation were statistically significant （ P 〈0. 05） . The difference of three items between 2 weeks after operation and 6 months after operation was not statistically significant（P〉0. 05）. Intraoperative complication was the mutilation of vortex vein in 1 eye （0. 9%）. Postoperative complications were retinal hemorrhage and orbit aseprtic inflammation in 1 eye （0. 9%） each. There were no severe complications, such as infection, retinal detachment or ischemic optic neuropathy. Conclusion Post-sclera reinforcement is a safe,effective method in treating high myopia with posterior scleral staphyloma. It could control the increase of axis length and diopter. It could stabilize or improve the vision.

关 键 词：近视 高度 后巩膜葡萄肿 后巩膜加固术 

分 类 号：R779.6[医药卫生—眼科]