广角观察系统下巩膜扣带术与常规巩膜扣带术治疗视网膜脱离的比较  

Comparison between the scleral buckling under wide-angle viewing systems and conventional scleral buckling for the treatment of rhegmatogenous retinal detachment

作　　者：李秀娟[1] 贾恒[1] 吕晓贝 葛自鹏 

机构地区：[1]郑州大学第一附属医院眼科,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2017年第6期420-424,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省科技厅科技攻关项目（142102310110）;河南省卫生和计划生育委员会项目（2014005）;河南省卫生厅科技攻关项目（201304007）

摘　　要：目的比较广角观察系统辅助下巩膜扣带术与常规巩膜扣带术治疗孔源性视网膜脱离的效果。方法回顾性分析108例（108只眼）孔源性视网膜脱离行巩膜扣带术的临床资料。随机分为两组：观察组（54只眼）在广角观察系统辅助下巩膜扣带术；对照组（54只眼）在常规间接检眼镜辅助下行巩膜扣带术。术前两组患者在年龄、性别、病程、视力、眼压、屈光度、视网膜脱离范围、有无黄斑脱离、视网膜下增生条索及视网膜裂孔数等方面差异均无统计学意义。随访时间为12个月。结果比较两组的手术时间、一次手术成功率、术后视力和并发症的情况。观察组的手术时间（联合或不联合环扎）明显短于常规组（t=-12．735，-18．037；P=0．000，0．000）。观察组的一次手术成功率为94．44％，与常规组的92．59％比较差异无统计学意义（χ^2=0．026，P=0．917）。术后1个月随访，观察组的视力优于常规组（t=-6．009，P=0．000）。两组之间视力在术后3个月（t=-1．202，P=0．214）、6个月（t=-0．084，P：0．657）及12个月（t=-1．216，P=0．355）随访时，差异均无统计学意义。结论广角观察系统辅助下巩膜扣带术效果良好，与常规巩膜扣带术相比手术时间较短，是孔源性视网膜脱离的可供选择的治疗方法。Objective To compare the efficacy between the scleral buckling under wide-angle viewing systems （WAVS） and conventional scleral buckling for rhegmatogenous retinal detachment. Methods The data of 108 eyes of 108 patients with rhegmatogenous retinal detachment was collected and retrospectively analyzed. All cases were randowly divided into two groups： 54 eyes underwent scleral buckling under WAVS （Group A ） , and 54 eyes underwent conventional scleral buckling under indirect ophthalmoscope （Group B）. Preoperatively, the difference were not statistically significant between the two groups in age, gender, course of disease, best corrected visual acuities （BCVA）, IOP, refractive error, the extent of retinal detachment, with or without macular detachment, subretinal demarcation line and the number of retinal breaks. The follow-up period was 12 months. Results Durations of operation, primary operative success rate, BCVA and complications were compared between the two groups. The durations of operation in Group A （with or without encircling operation） were obviously shorter than those in Group B （t = - 12. 735, - 18. 037 ; P =0. 000,0. 000）. The primary operative success rate was 94.44% in Group A and 92.59 % in Group B,the difference was not statistically significant （χ^2 = 0. 026,P = 0. 917 ）. The BCVA in Group A was better than that in Group B （ P 〈 0. 001 ） at 1 month after surgery. However, the difference was not statistically significant between the two groups at 3 （t = - 1. 202, P = 0. 214）, 6 （t = -0.084,P =0. 657）, and 12 monthes （t = -1. 216, P =0. 355） follow-up visits respectively. Conclusion The efficacy of scleral buckling under WAVS is good with shorter operative time. It may be an alternative choose for rhegmatogenous retinal detachment.

关 键 词：视网膜脱离 孔源性 巩膜扣带术 广角观察系统 

分 类 号：R779.6[医药卫生—眼科]