25-G玻璃体切割联合C3F8治疗下方孔源性视网膜脱离  

25-gauge pars plana vitrectomy and C3F8 gas for the repair of rhegmatogenous retinal detachment with inferior breaks

作　　者：曾苗[1] 陈晓[1] 洪玲[1] 晏颖[1] 朱丽[1] Zeng Miao; Chen Xiao; Hong Ling; Yan Ying; Zhu Li(Wuhan General Hospital, Wuhan 430070, China)

机构地区：[1]中国人民解放军广州军区武汉总医院眼科,武汉430070

出　　处：《中国实用眼科杂志》2017年第10期964-969,共6页Chinese Journal of Practical Ophthalmology

摘　　要：目的比较25-G微创玻璃体切割术联合玻璃体腔填充全氟丙烷（C3F8）气体治疗下方孔源性视网膜脱离（rhegmatogenous retinal detachment，RRD）与上方裂孔的RRD的临床效果。方法回顾性系列病例研究。选择2013年12月至2014年10月于中国人民解放军武汉总医院眼科检查确诊为RRD患者53例（53只眼）纳入研究，并根据视网膜裂孔的位置分为两组。其中A组21例（21只眼）为下方视网膜裂孔（4~8点位）的RRD患者，B组32例（32只眼）为上方裂孔（8~4点位）的RRD患者。所有患者均于确诊后1周内行25-G微创玻璃体切割术联合玻璃体腔填充C3F8气体。治疗后每月随访1次，每次随访均行最佳矫正视力、眼压、裂隙灯、间接眼底镜及眼底彩色照相检查，随访13~28个月，平均随访时间为18.4月，对比观察两组患者一次手术视网膜复位成功率，术后最佳矫正视力及术中、术后并发症。结果手术后12个月A组与B组一次手术成功率分别为85.7%、87.5%，差异无统计学意义（P〉0.05）。术后1、3、6及12个月A组与B组平均BCVA比较，差异均无统计学意义（P〉0.05），但两组术后平均BCVA均较术前明显提高，差异有统计学意义（A组F=2.481，P〈 0.05；B组F=3.558，P〈0.05）。两组患者术中及术后并发症比较，差异无统计学意义（P〉0.05）。结论25-G微创玻璃体切割术联合玻璃体腔填充C3F8气体是治疗下方裂孔合并RRD的有效方法，该方法治疗上方RRD的手术成功率与下方相比无明显差异。ObjectiveTo compare anatomical, functional outcomes and complications of 25-gauge pars plana vitrectomy（PPV） and perfluoropropane（C3F8） gas as tamponade between rhegmatogenous retinal detachment（RRD） with superior breaks and inferior breaks.MethodsFifty-three patients （53 eyes）affected with RRD were recruited. The eyes were divided into two groups. Group A （21 eyes） consisted of patients with inferior breaks（4-8 o’clock hours）. Group B （32eyes） consisted of patients with superior breaks（8-4 o’clock hours）. All the patients underwent a 25-gaugae PPV with 12% C3F8 gas tamponade, and examined with best-corrected visual acuity（BCVA）, intraocular pressure, slit-lamp, indirect fundoscopy and color fundus photography at baseline and each month of post-operation. The mean follow-up time was 18.4months （ranged 13~28 months）. The primary anatomic success rate, postoperative BCVA, and complications were compared.ResultsThe primary anatomic success rate was 85.7% for the Group A and 87.5% for the Group B（P 〉0.05） during the 12-month period of post-operation. In group A, the mean BCVA was improved significantly at 1 month, 3 months, 6 months and 12 months’ post-operation compared with baseline（F =2.481,P 〈0.05）, the similar outcome were found in group B（F =3.558 P 〈0.05）. No statistically significant difference was found in BCVA between the two groups during the 12 months’ follow-up（P 〉0.05）. No statistical difference was found in complications between the two groups（P 〉0.05）.Conclusions25-gauge PPV and C3F8 gas as tamponade is an effective and safe treatment method for RRD with inferior breaks. No differences in anatomical success rates are observed between RRD with superior breaks and inferior breaks.

关 键 词：孔源性视网膜脱离 25-G玻璃体切除术 下方裂孔 疗效 

分 类 号：R774.12[医药卫生—眼科]