16例复杂性脉络膜脱离型视网膜脱离的手术治疗  

Surgical treatment of 16 cases of complex rhegmatogenous retinal detachment associated with choroidal detachment

作　　者：董凯 闫原野 王一塞 李金平 柯根杰 Dong Kai;Yan Yuanye;Wang Yisai;Li Jinping;Ke Genjie(Department of Ophthalmology,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,Anhui 230001,China)

机构地区：[1]中国科学技术大学附属第一医院眼科

出　　处：《临床眼科杂志》2019年第6期527-529,共3页Journal of Clinical Ophthalmology

基　　金：国家自然科学基金(NSFC81400407);安徽省自然科学基金(AHNSF 1408085QH159);上海市眼底病重点实验室资助

摘　　要：目的探讨复杂性脉络膜脱离型视网膜脱离患者的手术方式及治疗效果。方法回顾性研究2017年12月至2018年7月我院收治的复杂性脉脱型视网膜脱离患者16例(16只眼)。收集所有患者术前、术中及术后随访期间的临床资料,进行综合分析。结果所有患者均行玻璃体切除联合硅油填充术。其中联合白内障手术7例,人工晶状体取出1例,根据术中情况采用剥膜、重水、激光、冷冻等手术处理。术后随访3~6个月。15例(93.75%)患者最终视网膜复位,1例(6.25%)患者术后短期出现视网膜再脱离;术前平均最佳矫正视力(LogMAR视力)(2.19±0.47),术后最后1次随访平均最佳矫正视力(LogMAR视力)(1.9±0.43);术前平均眼压4~0(6.7±1.8)mmHg,术后最后1次随访平均眼压9.7~27(17.9±5.8)mmHg(t=-7.47,P<0.01)。结论复杂性脉脱型视网膜脱离是特殊类型的视网膜脱离,术前激素的应用,术中采用预置灌注排出脉络膜上腔积液,辅助重水激光,联合白内障手术等手术处理,可以有效治疗此类疾病,保存患者残存视功能。Objective To investigate the operational manner and effect of rhegmatogenous retinal detachment associated with choroidal detachment(RRDCD).Methods Retrospective analysis 16 diagnosed complex RRDCD cases from December 2017 to July 2018 in our hospital.Collected the clinical data of all cases before,during and after operation.Results All cases were accepted vitrectomy combined with silicone oil filling.7 cases Combined cataract Phacoemulsification;IOL was taken out in 1 case,;membrane stripping,heavy water,laser and cryopreservation were performed according to intraocular conditions.15 cases(93.75%)had final retinal reattachment and 1 case(6.25%)had retinal redetachment.The mean best corrected visual acuity(LogMAR)was(2.19±0.47)before operation and the mean best corrected visual acuity(LogMAR)was(1.9±0.43)after the last follow-up.The mean intraocular pressure(IOP)before operation was 4-10(6.7±1.8)mmHg,the mean IOP was 9.7~27(17.9±5.8)mmHg after the last follow-up.(t=-7.47,P<0.01).Conclusions Complex RRDCD is a special type of rhegmatogenous retinal detachment.Preoperative application of corticosteroids,combined suprachoroidal drainage and cataract phacoemulsification,supplemented with heavy water,laser can effectively treated this kind of disease and the residual visual function of patient can be preserved.

关 键 词：脉络膜脱离型视网膜脱离 玻璃体切除术 糖皮质激素 

分 类 号：R47[医药卫生—护理学]