23G玻璃体切割术联合巩膜外垫压治疗下方裂孔伴增殖型孔源性视网膜脱离的疗效和安全性  

23-Gauge pars plana vitrectomy and scleral buckle for the treatment of proliferative rhegmatogenous retinal detachment with inferior breaks

作　　者：周怀胜 马海智 梁婉玲 曾山 黄慧君 晏世刚 ZHOU Huai Sheng;MA Hai Zhi;LIANG Wan Ling;ZENG Shan;HUANG Hui Jun;YAN Shi Gang(From the Department of Ophthalmology,Foshan Second Pepole’s Hospital,Foshan 528000,Guangdong Province,China)

机构地区：[1]第二人民医院眼科,广东省佛山市528000

出　　处：《眼科新进展》2018年第3期251-254,共4页Recent Advances in Ophthalmology

基　　金：广东省佛山市医学重点专科培育项目(编号:Fspy12015005);广东省佛山市十三五医学重点专科和特色专科建设(编号:FSGSPZD135020);广东省佛山市科技创新平台项目(编号:2013AG10012)

摘　　要：目的对比分析23G玻璃体切割术(pars plana vitrectomy,PPV)和23G PPV联合巩膜外垫压(scleral buckling,SB)(SB-PPV)治疗下方裂孔伴增殖型孔源性视网膜脱离的手术疗效和安全性。方法回顾性分析2013年1月至2016年12月我院收治的下方裂孔伴增殖型孔源性视网膜脱离患者70例(70眼),其中39眼行SB-PPV为SB-PPV组,31眼行PPV为PPV组。观察两组患眼一次手术视网膜复位率,术中晶状体损伤和视网膜切除比例,术后最佳矫正视力和眼压等的差异。结果 SB-PPV组有36眼(92.3%)一次手术视网膜复位,PPV组为23眼(74.2%),两组术后一次视网膜复位率相比差异有统计学意义(P=0.035)。SB-PPV组术中晶状体损伤1眼(2.6%),PPV组术中晶状体损伤6眼(19.4%),两组术中晶状体损伤率相比差异有统计学意义(P=0.021)。SB-PPV组视网膜切除2眼(5.1%),PPV组视网膜切除10眼(32.3%),两组视网膜切除眼数比例相比差异有统计学意义(P=0.008)。术后高眼压眼数比例以及术后1个月最佳矫正视力两组相比差异均无统计学意义(均为P>0.05)。结论 SB-PPV可提高下方裂孔伴增殖型孔源性视网膜脱离的一次手术视网膜复位率,且降低了术中晶状体损伤和视网膜切除的比例。ObjectiveTo compare the safety and efficacy of 23 Gauge pars plana vitrectomy(PPV)and PPV combined with scleral buckling PPV(SB PPV)in proliferative rhegmatogenous retinal detachments with inferior breaks.MethodsRetrospectively nonrandomized clinical case study was conducted in 70 patients with proliferative rhegmatogenous retinal detachment associated with inferior breaks between January 2013 and December 2016,including 39 eyes receiving SB PPV procedures as the SB PPV group and 31 eyes undergoing PPV procedures as the PPV group.And anatomical success rate for one procedure,lens trauma rate,retinotomy rate,postoperative best corrected visual acuity(BCVA)outcome and intraocular pressure(IOP)were recorded and analyzed.ResultsThe anatomical success rate for one procedure was 92.3%(36/39)in the SB PPV group and 74.2%(23/31)in the PPV group,and the difference was statistically significant(P<0.035).The lens trauma rate was 2.6%(1/39)in the SB PPV group and 19.4%(6/31)in PPV group,with the difference being statistically significant(P<0.05).The retinotomy rate was 5.1%(2/39)in the SB PPV group and 32.3%(10/31)in the PPV group,and the difference approached statistically significance(P<0.05).There was no significant difference in the postoperative BCVA and IOP between the two groups(both P>0.05).ConclusionSB PPV can increase the anatomical success rate for one procedure in patients with rhegmatogenous retinal detachment associated with inferior breaks,and reduce retinotomy rate and lens trauma rate.

关 键 词：视网膜脱离 玻璃体切割术 下方裂孔 巩膜外垫压术 

分 类 号：R774[医药卫生—眼科]