硅油取出联合巩膜扣带术对预防视网膜再脱离的疗效分析  

Analysis of the effect of silicone oil removal combined with scleral buckling on the prevention of retinal redetachment

作　　者：刘晓丹 任雁鹏 高延庆[1] LIU Xiaodan;REN Yanpeng;GAO Yanqing(Department of Ophthalmology,the Second People's Hospital of Zhengzhou City,Zhengzhou,4000,China)

机构地区：[1]郑州市第二人民医院眼科,河南郑州450000

出　　处：《实用防盲技术》2024年第3期93-96,共4页Journal of Practical Preventing Blind

摘　　要：目的评估硅油取出术中联合巩膜扣带术在预防前部增殖性玻璃体视网膜病变(PVR)或视网膜裂孔患者硅油取出术后视网膜再脱离的疗效分析。方法回顾性分析2021年1月-2023年1月在我院诊治的43例前部增殖性玻璃体视网膜病变患者(43只眼),均为玻切联合硅油填充术后3个月取硅油患者。术前经过三面镜检查,发现赤道前存在增殖性玻璃体视网膜病变(PVR)、新发网膜裂孔,术中光导直视下检查并定位PVR、裂孔位置,行巩膜外垫压或环扎术,并取出眼内硅油,手术后随访患者3个月,观察硅油取出术中联合巩膜扣带术对视网膜再脱离的预防疗效。结果视网膜复位率95.35%(41/43),术后3个月末患者视力视力指数>0.1者44.19%(19/43),0.06-0.1者51.16%(22/43),指数≤0.05者4.65%(2/43)优于术前的指数>0.1者25.58%(11/43),0.06-0.1者62.79%(27/43),指数≤0.05者11.63%(5/43),差异有统计学意义(U=1.9609,P=0.0499<0.05),所有患者均未出现明显并发症。结论对于存在前部PVR、赤道前视网膜裂孔的眼内硅油填充患者,行硅油取出术中联合巩膜扣带手术,视网膜复位效果良好且有利于患者术后视力的有效恢复。Objective To evaluate the efficacy of combined scleral buckling in the prevention of retinal redetachment after silicone oil removal in patients with anterior proliferative vitreoretinopathy(PVR)or retinal hole.Methods A retrospective analysis was performed on 43 patients(43 eyes)with anterior proliferative vitreoretinopathy or retinal hole treated in our hospital from January 2021 to January 2023,all of whom were patients with silicone oil taken 3 months after vitrectomy combined with silicone oil filling.Preequatorial proliferative vitreoretinopathy(PVR),new retinal hiatus or shallow retinal detachment were detected by a three-way endoscopic examination before surgery.During the operation,PVR and hiatus were examined and located under direct optical guidance,episcleral compression or circumligation was performed,and intraocular silicone oil was removed.The patients were followed up for 3 months after surgery.To observe the preventive effect of silicone oil extraction combined with scleral buckling on retinal redetachment.Results Retinal resetting rate was 95.35%(41/43),visual acuity index>0.1 was 44.19%(19/43),0.06-0.1 was 51.16%(22/43),index≤0.05 was 4.65%(2/43)better than preoperative index>0.1 was 25.58%(11/43),62.79%(27/43)of 0.06-0.1 patients,11.63%(5/43)of≤0.05 patients,the difference was statistically significant(U=1.9609,P=0.0499<0.05),and no significant complications occurred in all patients.Conclusion For patients with anterior PVR and anterior equatorial retinal hiatus,silicone oil removal combined with scleral buckling operation was performed,and the retinal restoration was good and conducive to the effective recovery of postoperative visual acuity.

关 键 词：硅油取出 巩膜扣带术 视网膜再脱离 疗效分析 

分 类 号：R779.6[医药卫生—眼科]