25G眼内光纤辅助巩膜外垫压术治疗孔源性视网膜脱离的效果观察  

Effect observation on 25G chandelier endoilluminator-assisted external scleral buckling in the treatment of rhegmatogenous retinal detachment

作　　者：王渝龙 谯雁彬 詹天顺 聂昕 WANG Yulong;QIAO Yanbin;ZHAN Tianshun;NIE Xin(Department of Ophthalmology,Chongqing People’s Hospital,Chongqing 400013,China)

机构地区：[1]重庆市人民医院眼科,重庆市400013

出　　处：《微创医学》2021年第5期616-619,共4页Journal of Minimally Invasive Medicine

摘　　要：目的观察25G眼内光纤辅助下巩膜外垫压术治疗孔源性视网膜脱离(RRD)的临床疗效。方法回顾性分析23例(23眼)选择25G光纤作为眼内照明,通过非接触广角成像系统观察眼底并完成巩膜外垫压术的RRD患者的临床资料。观察手术前后最佳矫正视力(BCVA)的改变、视网膜复位情况和手术相关并发症情况。结果所有患者术后随访6~12(7.60±4.31)个月。21例(91.3%)患者术后视网膜一次解剖复位,未复位的2例(8.7%)给予玻璃体切除联合硅油填充手术,二次术后视网膜均复位。20眼(87.0%)术后视力提高。手术前BCVA(0.22±0.19)与手术后BCVA(0.47±0.27)比较,差异有统计学意义(P<0.05)。术中1例(4.3%)患者发生玻璃体丢失,3例(13.0%)术后眼压高,6例(26.1%)发现有光纤入路相关的玻璃体损伤。未发现玻璃体积血、感染性眼内炎、晶状体损伤等光纤相关并发症。结论25G眼内光纤辅助的巩膜外垫压术治疗RRD是安全、有效的。Objective To observe the clinical efficacy of external scleral buckling in the treatment of rhegmatogenous retinal detachment(RRD)using 25G chandelier endoilluminator.Methods The clinical data of 23 RRD patients(23 eyes),who were completed external scleral buckling by selecting 25G optical fiber as intraocular illuminator,and via a non-contact wide-angle viewing system to observe fundus,were analyzed retrospectively.Changes of best corrected visual acuity(BCVA)before and after surgery,retinal attachment condition and surgery-related complications were observed.Results All patients were followed up for 6 to 12(7.60±4.31)months.A total of 21 cases(91.3%)accomplished anatomical reduction of retina at one time after surgery,while 2 cases(8.7%)without reduction were treated with vitrectomy combined with silicone oil tamponade,and they achieved retinal reduction after the second surgery.Visual acuity improved in 20 eyes(87.0%)after surgery.There was a statistically significant difference of BCVA before and after surgery[(0.22±0.19)vs.(0.47±0.27),P<0.05].Intraoperative vitreous loss occurred in 1 patient(4.3%),postoperative intraocular hypertension in 3 patients(13.0%),and vitreous injury associated with optical fiber approach was found in 6 patients(26.1%).No optical fiber-related complications such as vitreous hematocele,infective endophthalmitis and lens injury occurred.Conclusion 25G chandelier endoilluminator-assisted external scleral buckling for RRD is safe and effective.

关 键 词：巩膜外垫压术 孔源性视网膜脱离 25G眼内光纤 非接触广角成像系统 

分 类 号：R774.12[医药卫生—眼科]