术前未发现裂孔的环扎术后复发性视网膜脱离的双环扎手术疗效  

Second Encircling Procedure for Repair of Recurrent Retinal Detachment with Unseen Hole

作　　者：王刚[1] 桂君民[1] 李佩娟[1] 蔡文泉[2] 张皙[2] 

机构地区：[1]重庆市第三人民医院眼科,重庆400014 [2]上海市第一人民医院眼科,上海200080

出　　处：《华西医学》2003年第3期339-340,共2页West China Medical Journal

摘　　要：目的 :评价双环扎手术对术前未发现裂孔的复发性视网膜脱离的治疗效果。方法 :对从 1998年 4月至 2 0 0 1年 4月在上海市第一人民医院眼科接受双环扎手术治疗的 16例 (16只眼 )术前未发现裂孔的复发性视网膜脱离患者进行了回顾分析。 16例患者有 9例在术中发现有靠近锯齿缘的细小裂孔。对发现的裂孔和可疑的变性均冷冻处理 ,保留原环扎带 ,将第二条硅胶环扎带置于裂孔或可疑变性部位 ,与原环扎带间距 3 71± 0 6 5mm。其中一例因PVR严重联合做玻璃体手术和C3 F8气体填充 ,术中有 4例放视网膜下液 ,3例有过玻璃体手术史患者放玻璃体液并用 30 %C3 F8气体填充。结果 :除联合做玻璃体手术的患者术后脱离的视网膜未愈经再手术硅油填充获愈外 ,其余 15例脱离的视网膜均一次性复位。术后随访最短 3个月 ,最长 11个月 ,平均随访 4 1个月。除 1例发现有浅的网膜脱离外 ,其余视网膜复位良好 ,最终复位度 93 8%。结论Objective:To evaluate the effects of second encircling procedure in the treatment of recurrent retinal detachment with unseen hole after a previous encircling procedure.Metheod:The second necirling bands were placed around the site in which a retinal tear or suspected retinal tear was detected during surgery,at an average of 3 71±0 65mm distance from the first band.All sixteen cases with recurrent retinal detachment and an unseen hole were treated with another encircling procedure alone except one case who had combined with vitrcetomy.Results:The retina was reattached with a single opreration in all eyes except one who had combined with vitrectomy,the latter was resolved by second operation with silicone oil tamponade.The retina remained attached in all eyes during follow-up except one eye had small subretinal fluid.Conclusions:Second encircling procedure can treat recurrent retinal detachment with unseen hole effectively when there is no significant proliferative vitreretinapathy.

关 键 词：术前 环扎术 复发性视网膜脱离 双环扎手术 

分 类 号：R779.6[医药卫生—眼科]