后巩膜加固术治疗伴后巩膜葡萄肿的近视性黄斑劈裂的效果  

The efficacy of posterior scleral reinforcement for myopic macular retinoschisis with posterior staphyloma

作　　者：韩金凤 李梦迪 金学民 戴方方 王艳婷 Han Jinfeng;Li Mengdi;Jin Xuemin;Dai Fangfang;Wang Yanting(Department of Ophthalmology,People′s Hospital of Zhengzhou University,Henan Provincial People′s Hospital,Henan Eye Hospital,Henan Eye Institute,Zhengzhou 450003,China)

机构地区：[1]郑州大学人民医院眼科河南省人民医院河南省立眼科医院河南省眼科研究所,郑州450003

出　　处：《中华眼外伤职业眼病杂志》2020年第4期252-257,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省科技攻关项目(162102410004)。

摘　　要：目的:观察后巩膜加固术治疗伴后巩膜葡萄肿的近视性黄斑劈裂的效果。方法:回顾性研究。分析河南省立眼科医院2017年5月至2019年6月行后巩膜加固术治疗的近视性黄斑劈裂伴后巩膜葡萄肿27例(30只眼)的临床资料。分析手术前后视力、光学相干断层扫描(OCT)及手术并发症情况。术后随访至少6个月。结果:术后6个月OCT示8只眼(26.7%)劈裂腔完全消失,17只眼(56.7%)劈裂腔大部分明显减小,5只眼(16.7%)未愈。术后视力(logMAR)1.00(0.575,1.300)较术前的1.25(0.800,1.300)提高(P=0.046)。随访期间无黄斑孔或眼内炎等严重并发症发生。结论:近视性黄斑劈裂伴后巩膜葡萄肿行后巩膜加固术可以有效地减少劈裂腔高度及提高视力,但也存在一定的手术风险。Objective To observe the efficacy of posterior scleral reinforcement for myopic macular retinoschisis(MRS)with posterior staphyloma(PS).Methods This was a retrospective study.The clinical data of 30 eyes of 27 cases of MRS with PS treated with posterior scleral reinforcement from May 2017 to Jun.2019 in Henan Provincial Eye Hospital were analyzed.Best corrected visual acuity(BCVA),optical coherence tomography(OCT)and surgery complications were analyzed before and after surgery.The follow-up time was more than 6 months after surgery.Results At 6 months after surgery,OCT examination showed complete retinoschisis resolution in 8 eyes(26.7%),partial resolution in 17 eyes(56.7%)and slightly changed in 5 eyes(16.7%).The BCVA(logMAR)was improved from 1.25(0.800,1.300)preoperatively to 1.00(0.575,1.300)postoperatively(P=0.046).No severe complication such as macular hole or endophthalmitis occurred during the follow-up time.Conclusion Posterior scleral reinforcement for MRS with PS can effectively reduce the height of splitting cavity and improve visual acuity,but surgical risks should be considered.

关 键 词：近视 巩膜 加固术 后巩膜 视网膜劈裂 黄斑 葡萄肿 巩膜 

分 类 号：R779.6[医药卫生—眼科]