改良巩膜扣带术治疗孔源性视网膜脱离的疗效观察  

Observation on the efficacy of modified scleral buckling for rhegmatogenous retinal detachment

作　　者：崔璨[1] 李秀娟[1] 王媛 张金嵩[1] Cui Can;Li Xiujuan;Wang Yuan;Zhang Jinsong(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China;Department of Ophthalmology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China)

机构地区：[1]郑州大学第一附属医院眼科河南省眼科医院,郑州450052 [2]郑州大学附属郑州中心医院眼科,450007

出　　处：《中华眼外伤职业眼病杂志》2020年第6期418-422,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省自然科学基金(182300410339);河南省高等学校重点科研项目(19A320076);河南省医学科技攻关计划联合共建项目(2018020799)。

摘　　要：目的评价25 G光纤内照明及角膜接触镜辅助下巩膜扣带术治疗单纯性孔源性视网膜脱离的效果。方法回顾性分析郑州大学第一附属医院2015年6月至2019年6月孔源性视网膜脱离52例(52只眼)的临床资料。患者均在25 G光纤内照明及角膜接触镜辅助下行改良巩膜扣带术。术后随访6个月。结果一次手术视网膜复位49例(94.23%);未复位的3例中,1例再次行巩膜扣带术;2例行玻璃体切除+硅油填充术。术后6个月,视力优于术前(t=8.476,P=0.000)。术后平均眼压为(13.35±2.24)mmHg(1 mmHg=0.133 kPa),与术前相比差异无统计学意义(t=-1.762,P=0.084)。随访期间未发生医源性视网膜裂孔、玻璃体嵌顿、眼内炎、白内障进展或角膜水肿等并发症。结论改良式巩膜扣带术治疗单纯性孔源性视网膜脱离操作简便,优势明显,且并发症少。Objective To evaluate the efficacy of 25 G optical fiber endoillumination and corneal contact lens assisted scleral buckling for the treatment of simple rhegmatogenous retinal detachment.Methods The clinical data of 52 eyes of 52 patients with rhegmatogenous retinal detachment from Jun.2015 to Jun.2019 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.All patients underwent modified scleral buckling assisted with the 25 G optical fiber endoillumination and corneal contact lens.All patients were observed and followed up for 6 months.Results A total of 49 eyes(94.23%)achieved retinal reattachment after operation.Among 3 cases without retinal reattachment,1 case underwent scleral buckling again,2 cases underwent vitrectomy with silicone oil tamponade.At 6 months after operation,the visual acuity was better than that before operation(t=8.476,P=0.000).The average intraocular pressure was(13.35±2.24)mmHg(1 mmHg=0.133 kPa).The difference was statistically significant before and after operation(t=-1.762,P=0.084).No complication such as iatrogenic retinal hole,vitreous incarceration,endophthalmitis,cataract progression or corneal edema occurred.Conclusion The modified scleral buckling is a safe and effective method for the treatment of simple rhegma togenous retinal detachment because of its simple operation,obvious advantages and few complications.

关 键 词：视网膜脱离 单纯性 巩膜扣带术 接触镜 角膜 

分 类 号：R779.6[医药卫生—眼科]