微创玻璃体切割手术联合改良脉络膜上腔引流治疗脉络膜脱离型视网膜脱离的疗效观察  

Clinical effect of minimally invasive vitreoretinal surgery combined with a modified suprachoroidal drainage surgery for retinal detachment associated with choroidal detachment

作　　者：高韶晖 路小楠 栗占荣 裴晗 赵朝霞 郭希让 李蕴随 

机构地区：[1]河南省人民医院 郑州大学人民医院河南省立眼科医院河南省眼科研究所,郑州450003

出　　处：《中华眼底病杂志》2018年第2期116-119,共4页Chinese Journal of Ocular Fundus Diseases

基　　金：国家自然科学基金-河南人才培养联合基金（U1304811）

摘　　要：目的 观察微创玻璃体切割手术（MIV）联合改良脉络膜上腔引流治疗脉络膜脱离型视网膜脱离（RRDCD）的疗效。 方法 前瞻性临床研究。临床检查确诊的RRDCD患者27例27只眼纳入研究。其中，男性16例，女性11例；均为单眼。平均年龄（53.67±14.82）岁；平均眼压（8.20±2.10）mmHg（1 mmHg=0.133 kPa）；平均最小分辨角对数（logMAR）最佳矫正视力（BCVA）为1.87±0.58。所有患眼均行23G MIV联合改良脉络膜上腔引流手术，手术中利用1 ml注射针头和23G穿刺套管进行微创脉络膜液体引流。手术后随访3个月，观察手术后1、10 d，1、3个月的BCVA、眼压、视网膜复位率及手术并发症等情况。 结果 手术后1、10 d，1、3个月平均logMAR BCVA分别为1.62±0.67、1.51±0.63、1.39±0.54、1.32±0.56；平均眼压分别为（13.47±5.06）、（14.43±4.09）、（14.89±4.30）、（15.38±3.37）mmHg。与手术前logMAR BCVA、眼压比较，差异均有统计学意义（F=6.19、15.21，P＜0.05）。手术后1、10 d所有患眼视网膜均复位良好，占100.0%；手术后1、3个月，视网膜复位良好者为24、23只眼，分别占88.9%、85.2%。随访期间未发生感染性眼内炎、脉络膜上腔出血等严重手术并发症。 结论 MIV联合改良脉络膜上腔引流手术治疗RRDCD可提高患眼裂孔闭合率，改善视力；治疗RRDCD安全有效。Objective To observe the clinical effect of minimally invasive vitreoretinal （MIV） surgery combined with a modified suprachoroidal drainage surgery for retinal detachment associated with choroidal detachment （RRDCD）. Methods A prospective clinical study. A total of 27 patients （27eyes） diagnosed as RRDCD were recruited in this study. There were 16 males and 11 females, with an average of （53.67±14.82） years. The mean intraocular pressure （IOP） was （8.2±2.1） mmHg （1 mmHg=0.133 kPa） and best corrected visual acuity （BCVA） of minimum resolution angle logarithm （logMAR） was 1.87±0.58. All subjects underwent 23G MIV combined a modified suprachoroidal drainage surgery, which 23G stab knife and 1 ml syringe needle were used for surgery. The visual outcome, IOP, rate of retinal reattachment and complications were comparatively analyzed preoperatively and postoperatively. Results At 1 day, 10 days, 1 month and 3 months after surgery, the average of logMAR BCVA were 1.62±0.67, 1.51±0.63, 1.39±0.54, 1.32±0.56 and the mean of IOP were （13.47±5.06）, （14.43±4.09）, （14.89±4.30）, （15.38±3.37） mmHg, respectively. There were significant differences of logMAR BCVA and IOP between before and after surgery （F=6.19, 15.21; P〈0.05）. Retinal reattachments were achieved in 27 eyes （100%） at 1 day and 10 days after surgery. At 1 month and 3 months after surgery, the rate of retinal reattachment were 88.89% （24 eyes） and 85.19% （23 eyes）, respectively. No severe complications such as endophthalmitis and choroidal hemorrhage were found at follow-up visits. Conclusion MIV combined with a modified suprachoroidal drainage surgery is an effective and safe treatment for RRDCD, which can promote retina tear closure, improve visual acuity.

关 键 词：视网膜脱离/外科学 玻璃体切除术 治疗结果 

分 类 号：R774.1[医药卫生—眼科]