最小量外路手术与玻璃体切割术治疗孔源性视网膜脱离的对比研究  

Comparative study of minimal external route surgery and vitrectomy for rhegmatogenous retinal detachment

作　　者：张翠文 谢林英[2] 刘琳琳[2] 吴维霖 蒋贻平[2] ZHANG Cui-wen;XIE Lin-ying;LIU Lin-lin;WU Wei-lin;JIANG Yi-ping(The First Clinical Medical School of Gannan Medical University;Department of Ophthalmology,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医学院第一临床医学院,江西赣州341000 [2]赣南医学院第一附属医院眼科,江西赣州341000

出　　处：《赣南医学院学报》2023年第8期817-820,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:对比最小量外路手术与玻璃体切割伴硅油填充术在治疗孔源性视网膜脱离(Rhegmatogenous retinal detachment,RRD)中的疗效。方法:选择2011年1月至2016年12月于赣南医学院第一附属医院眼科就诊的518例RRD(黄斑裂孔除外)患者为研究对象。其中,258例行最小量外路手术(外路组);260例行玻璃体切割伴硅油填充术(玻璃体切割组)。术后随访6个月,比较两组视网膜复位率、最佳矫正视力以及并发症情况。结果:首次手术视网膜复位成功率在外路组及玻璃体切割组分别为96.90%和93.46%,差异无统计学意义(P>0.05)。外路组术后1、3、6月视力提高4行患者比率分别为37.60%、43.41%、48.84%,提高2~4行的患者比率分别为:41.08%、44.57%、46.51%,提高不足2行患者的比率分别为:21.32%、12.02%、4.65%;玻璃体切割组术后1、3、6月视力提高4行的患者比率分别为15.77%、19.23%、21.54%,提高2~4行的患者比率分别为:31.54%、36.15%、37.31%,提高不足2行或视力下降的患者比率分别为:52.69%、44.62%、41.15%,1、3、6个月外路组手术患者视力改善幅度均较玻璃体切割组大,差异有统计学意义(P<0.05)。外路组和玻璃体切割组术后高眼压的发生率分别为1.94%、26.15%,白内障发生率分别为0%、89.23%,外路组白内障和高眼压发生率均小于玻璃体切割组,差异有统计学意义(P<0.05)。结论:虽然最小量外路手术与玻璃体切割术伴硅油填充术治疗孔源性视网膜脱离的首次手术视网膜复位成功率无明显差异,但最小量外路手术患者术后视力收益较好,并发症更少。Objective:To compare the efficacy of minimal external route surgery and vitrectomy with silicone oil tamponade in the treatment of rhegmatogenous retinal detachment(RRD).Methods:A total of 518 patients with RRD(except macular hole)who were admitted to the Department of Ophthalmology,the First Affiliated Hospital of Gannan Medical University from January 2011 to December 2016 were selected as the study subjects.Among them,258 patients underwent minimal external route surgery(external route surgery group);260 patients underwent vitrectomy with silicone oil tamponade(vitrectomy group).After 6 months of follow-up,the retinal reattachment rate,best corrected visual acuity and complications were compared between the two groups.Results:The success rate of first surgeries of retinal reattachment in the external route surgery group and vitrectomy group was 96.90%and 93.46%,respectively,and the difference was not statistically significant(P>0.05).In the external route surgery group,the ratios of patients with visual acuity improved by four lines at 1,3 and 6 months after operation were 37.60%,43.41%and 48.84%,respectively.The ratios of patients with visual acuity improved by two straight lines were 41.08%,44.57%and 46.51%,respectively.The ratios of patients with visual acuity improved by less than two lines were 21.32%,12.02%and 44.65%,respectively.In the vitrectomy group,the postoperative visual acuity improved by 15.77%,19.23%,and 21.54%at 1,3,and 6 months after surgery,respectively.The ratios of two straight lines and four lines were increased by 31.54%,36.15%,and 37.31%,respectively.The ratios of less than two linesor decreased were increased by 52.69%,44.62%,and 41.15%,respectively.At 1,3,and 6 months after surgery,the visual acuity improvement of patients in the external route surgery was larger than that in the vitrectomy group,and the difference was statistically significant(P<0.05).The incidence of postoperative high intraocular pressure in the and the vitrectomy group was 1.94%and 26.15%respectively,and the incid

关 键 词：孔源性视网膜脱离 最小量外路手术 玻璃体切割术 硅油填充术 

分 类 号：R774.12[医药卫生—眼科]