巩膜扣带术联合术中玻璃体腔注气治疗上方“灌通式裂孔”视网膜脱离  

Management of superior rhegmatogenous retinal detachment by scleral buckling combined with intravitreal gas injection

作　　者：张桐[1,2] 刘旭阳 张国明[1,2] 王凡寅 Zhang Tong;Liu Xuyang;Zhang Guoming;Wang Fanyin(Jinan University,Affiliated Shenzhen Eye Hospital of Jinan University,Shenzhen Eye Hospital,Shenzhen Key Laboratory of Ophthalmology,Ocular Trauma Treatment and Stem Cell Differentiation Public Service Platform of Shenzhen,Shenzhen 518040,China)

机构地区：[1]暨南大学附属深圳眼科医院,深圳市眼科医院,深圳眼科学重点实验室 [2]深圳市眼外伤治疗与干细胞定向分化公共服务平台

出　　处：《中国实用眼科杂志》2017年第9期917-920,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的介绍巩膜扣带术联合玻璃体腔注气治疗上方“灌通式裂孔”视网膜脱离的手术方法。方法回顾性分析2015年1月1日至2017年4月30日间，经同一术者手术治疗的13例上方视网膜“灌通式裂孔”的视网膜脱离病例。其中单纯外加压联合玻璃体注气术11例，外加压联合巩膜环扎术联合玻璃体注气2例。术后需体位配合。结果13例手术全部获得成功，视网膜解剖学复位，其中10例随访6个月以上，未复发；2例随访3个月，未复发；1例随访1个月，未复发。13例均有不同程度的视力提高。结论在准确把握手术适应症的前提下，巩膜扣带术联合玻璃体腔注气在治疗上方视网膜“灌通式”裂孔的孔源性视网膜脱离中有着良好确切的效果，易于基层医院采用。Objective To introduce the clinical application of scleral buckling combined with in-travitreal gas injection for the treatment of superior rhegmatogenous-retinal detachment. Methods In this study, 13 cases of superior rhegmatogenous retinal detachment treated by the same surgeon Were selected from January 1st 2015 to April 30th 2017 retrospectively. Among them, there were 9 males and 4 females, aged from 26 to 72 years old. All the patients were healthy and could meet the post-operative posture requirements. Furthermore, the PVR grade was A-B, and the range of separation was at the 8 o＇clock-4 o＇clock position. Meanwhile, 9 cases of detachment involved the macula, and the remaining cases showed no involvement of the macula. The size of the retinal fissure was about 0.5PD-1.5PD, 10 cases of the retinal fissure were horseshoe-shaped, and the other 3 cases indicated lattice degeneration of the retina. The retinal fissure was observed to be located at the equator or slightly inferior to the posterior pole. Operation with simple external pressure combined with intravit-real gas injection were performed in the 11 cases of patients, and the other 2 patients were treated based on the application of external pressure combined with scleral buckling and intravitreal gas in-jection. The specific operation procedures were： the conjunctiva was routinely opened during the oper-ation, lifted muscles according to the location of the retinal fissure, the approximate location of the retinal fissure was determined under the binocular indirect ophthalmoscope, partial subretinal fluid were released by sclerotic puncture near the retinal fissure. Afterwards, 0.5-0.8ml sterile filtered gas was injected into the vitreous cavity, the retinal fissure was then frozen under direct vision. Follow- ing positioning, the silica gel block was fixed, and external prop pressure was performed subsequent- ly to locate the retinal fissure on the crest of the operation. Postoperative posture coordination was required for surgical patients. Resul

关 键 词：巩膜扣带术 玻璃体注气 视网膜脱离 

分 类 号：R774.12[医药卫生—眼科]