人工晶状体眼视网膜脱离玻璃体切除术的治疗效果  

Efficacy of vitrectomy for the pseudophakic retinal detachment

作　　者：李铮[1] 王瑞峰[1] 高雪霞[1] 唐文建[1] 

机构地区：[1]郑州市第二人民医院眼科,450006

出　　处：《中华眼外伤职业眼病杂志》2017年第1期55-58,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的 观察人工晶状体眼视网膜脱离在非接触式广角镜下行25 G＋玻璃体切除术的治疗效果.方法 人工晶状体眼视网膜脱离71例（71只眼）,在非接触式广角镜下行25 G＋玻璃体切除术治疗.对术后视网膜情况、视力及并发症等进行观察和分析.结果 术后随访时间3 ～12个月,一次手术视网膜复位66眼（92.96％）.视网膜未复位的5眼中,2眼行2次硅油填充手术,1眼行3次硅油填充手术后视网膜复位;另2眼因严重PVR以致视网膜无法复位而放弃治疗.最终视网膜复位69眼（97.18％）.平均视力（log MAR）术前为1.95 ±0.95,术后3个月为1.69±0.81,术后6个月为1.35±0.75,术后6个月与术前相比差异有统计学意义（t=14.547,P=0.000）;术后3个月与术前相比差异亦有统计学意义（t =7.535,P=0.000）.术后发生高眼压2眼,经降眼压药物治疗恢复正常;前房硅油1例;黄斑前膜1例.结论 采用非接触式广角镜下25 G＋玻璃体切除术治疗人工晶状体眼视网膜脱离,能够提高手术成功率,减少术中损伤及并发症发生,获得良好解剖和功能效果,是安全有效的治疗方法.Objective To observe efficacy of 25 G ＋ vitrectomy system with non contact wide angle lens in the treatment of pseudophakic retinal detachment.Methods A total of 71 eyes of 71 cases with pseudophakic retinal detachment were enrolled and underwent 25 G ＋ vitrectomy with non contact wide angle lens.The postoperative condition of retina,postoperative vision and complications were observed and analyzed.Results The follow-up time was 3-12 months,the retina was reattached successfully after once operation in 66 eyes （92.96%）.Two eyes received second operations and a third in 1 eye to achieve retinal reattachment.The retinal detachment of severe PVR occurred was untreatable in 2 eyes.Finally there were 69 eyes （97.18%） achieved retinal reattachment.Preoperative mean visual acuity （logMAR） was （1.95 ± 0.95） compared with （1.69 ± 0.81） at 3 months after surgery,the difference was significant between them （t =7.535,P =0.000）.At 6 months after surgery,the mean visual acuity was （1.35 ± 0.75） compared with the preoperative one the difference was statistically significant （t =14.547,P =0.000）.The postoperative complications were ocular hypertonia in 2 eyes,1 eye with macular epiretinal membrane and 1 eye with silicone oil in anterior chamber.Conclusion 25 G ＋ vitrectomy system with non contact wide angle lens for the treatment of pseudophakic retinal detachment is a safe and effective therapy to achieve a high anatomic and functional success rate with few complications.

关 键 词：视网膜脱离 人工晶状体眼 非接触式广角镜 玻璃体切除术 25 G+ 

分 类 号：R779.6[医药卫生—眼科]