前房灌注联合玻璃体手术治疗伴有脉络膜脱离的视网膜脱离  

Anterior chamber perfusion combined with vitrectomy for the treatment of retinal detachment with choroidal detachment

作　　者：曲申[1] 林梦真 牛耘丽[1] 韩雯婷[1] 徐海玥 张娟 毕燕龙[1] 荣翱[1] Qu Shen;Lin Mengzhen;Niu Yunli;Han Wenting;Xu Haiyue;Zhang Juan;Bi Yanlong;Rong Ao(Department of Ophthalmology,Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China;Department of Ophthalmology,Kongjiang Hospital of Yangpu District in Shanghai,Shanghai 200082,China)

机构地区：[1]同济大学附属同济医院眼科,上海200065 [2]上海市杨浦区控江医院眼科,200082

出　　处：《中华眼外伤职业眼病杂志》2019年第8期567-571,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价前房灌注联合玻璃体切除术治疗伴有脉络膜脱离的视网膜脱离的效果。方法回顾性分析2017年1月至2018年2月在同济大学附属同济医院眼科就诊的伴有脉络膜脱离的视网膜脱离者16例(16只眼)的临床资料。所有患者在前房灌注的辅助下行玻璃体切除联合硅油填充术,术后随访6个月以上。结果术后1天至3个月所有患者视网膜均复位,复位率达100%。术后6个月,在硅油取出术中发现视网膜再次脱离1例,进行硅油置换。术后1、3及6个月,视力(LogMAR)依次为1.75±0.45、1.50±0.53、1.33±0.66,与手术前比较,差异有统计学意义(F=59.58,P=0.001)。术后1、3及6个月,眼压依次为(12.67±6.91)mmHg、(14.35±6.75)mmHg、(15.12±6.16)mmHg(1mmHg=0.133 kPa)。与术前比较,差异均有统计学意义(F=2.26,P=0.01)。结论玻璃体切除术联合前房灌注可有效治疗伴有脉络膜脱离的视网膜脱离。脉络膜及视网膜复位情况较好,视力有一定改善。Objective To evaluate the efficacy of anterior chamber perfusion combined with vitrectomy for the treatment of retinal detachment with choroidal detachment.Methods The data of 16 eyes of 16 patients of retinal detachment with choroidal detachment from Jan.2017 to Feb.2018 in Tongji Hospital affiliated to Tongji University were collected and retrospectively analyzed.All cases received vitrectomy combined silicone oil tamponade assisted with anterior chamber perfusion.The follow-up time was more than 6 months.Results At 1 day to 3 months after operation,the retina of all patients were reattached,the reattached rate was 100%.At 1,3 and 6 months postoperatively,the visual acuity(LogMAR)were 1.75±0.45,1.50±0.53,1.33±0.66,the difference was significant between before and after operation(F=59.58,P=0.001).The IOP were(12.67±6.91)mmHg,(14.35±6.75)mmHg and(15.12±6.16)mmHg at 1,3 and 6 months postoperatively,respectively(1 mmHg=0.133 kPa).The difference was statistically significant between before and after operation(F=2.26,P=0.01).Conclusion Anterior chamber perfusion combined with vitrectomy for the treatment of retinal detachment with choroidal detachment is effective.After surgery,the choroid and retina are reattached well,and the visual acuity is improved.

关 键 词：脱离 视网膜 脱离 脉络膜 玻璃体切除术 灌注 前房 

分 类 号：R73[医药卫生—肿瘤]