全氟丙烷填充术后玻璃体切除术治疗脉络膜脱离型孔源性视网膜脱离  

Vitrectomy after perfluoropropane tamponade in the treatment for rhegmatogenous retinal detachment associated with choroidal detachment

作　　者：徐强[1,2] 周颖[1] 杜姝[1] 查优优 杨勋[1] Xu Qiang;Zhou Ying;Du Shu;Cha Youyou;Yang Xun(Department of Ophthalmology,Lixiang Eye Hospital of Soochow University,Suzhou 215031,China;Department of Ophthalmology,Lianyungang Second People’s Hospital,Lianyungang Cancer Hospital,Lianyungang 222000,China)

机构地区：[1]苏州大学理想眼科医院眼科,苏州215031 [2]连云港市第二人民医院眼科、连云港市肿瘤医院,连云港222000

出　　处：《中华眼外伤职业眼病杂志》2023年第6期401-406,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：江苏省科技厅基础研究计划青年基金项目(BK20200209)。

摘　　要：目的观察玻璃体内全氟丙烷(C_(3)F_(8))填充术后行27 G经睫状体平坦部玻璃体切除术(PPV)治疗脉络膜脱离型孔源性视网膜脱离(RRD-CD)的效果。方法回顾性病例系列研究。收集苏州大学理想眼科医院2019年1月至2021年12月先行玻璃体内C_(3)F_(8)填充术,术后2~4 d再行PPV治疗的RRD-CD连续性病例32例(32只眼)。术后随访6~15个月,记录玻璃体内C_(3)F_(8)填充术前后眼压变化、脉络膜脱离改善情况、PPV术后眼压波动,视力(logMAR)变化及视网膜复位率。结果玻璃体内C_(3)F_(8)填充术前眼压(5.90±1.68)mmHg,注气后48 h眼压升高为(16.52±4.73)mmHg(t=7.39,P<0.001);脉络膜脱离程度术前轻度3只眼、中重度29只眼,术后轻度7只眼,25只眼完全恢复(Z=3.82,P<0.001);术后1周,1个月及6个月视力(1.69±0.28、1.35±0.40、1.26±0.59)较术前(2.16±0.52)改善(F=37.56,P<0.001);PPV术后眼压无明显波动(F=1.69,P=0.165);视网膜复位率为84.38%(27/32)。结论玻璃体内C_(3)F_(8)填充术后再行27 G PPV治疗RRD-CD安全、有效。Objective To observe the efficacy of 27 G pars plana vitrectomy(PPV)after perfluoropropane(C_(3)F_(8))tamponade in the treatment for rhegmatogenous retinal detachment associated with choroidal detachment(RRD-CD).Methods This was a retrospective case series study.From Jan.2019 to Dec.2021,32 eyes of 32 patients with continuous RRD-CD were treated with 27 G PPV at 2-4 days after C_(3)F_(8)tamponade in Lixiang Eye Hospital of Soochow University.The changes of intraocular pressure before and after C_(3)F_(8)tamponade,improvement of choroidal detachment,fluctuation of intraocular pressure after PPV,changes of visual acuity(logMAR)and retinal reattachment rate were recorded during the 6-15 months of postoperative follow-up.Results The intraocular pressure before C_(3)F_(8)tamponade was(5.90±1.68)mmHg,and intraocular pressure at 48 h after C_(3)F_(8)tamponade increased to(16.52±4.73)mmHg(t=7.39,P<0.001).Degree of choroidal detachment was mild in 3 eyes,moderate and severe in 29 eyes before surgery;which was mild in 7 eyes and completely recovered in 25 eyes after surgery(Z=3.82,P<0.001).Visual acuity improved at 1 week,1 month and 6 months(1.69±0.28,1.35±0.40,1.26±0.59)compared to preoperation(2.16±0.52)(F=37.56,P<0.001).There was no significant fluctuation of intraocular pressure after PPV(F=1.69,P=0.165)and the retinal reattachment rate was 84.38%(27/32).Conclusion 27 G PPV after C_(3)F_(8)tamponade in the treatment of RRD-CD is safe and effective.

关 键 词：视网膜脱离 视网膜穿孔 氟碳化合物 气体 玻璃体切除术 脱离 脉络膜 眼压 

分 类 号：R779.6[医药卫生—眼科]