显微镜直视下巩膜外顶压并冷凝治疗孔源性视网膜脱离的临床研究  

Treatment of rhegmatogenous retinal detachment by indentation combined with cryoretinopexy under microscope

作　　者：霍鸣[1] 靳昆[1] 李娟[1] 刘文[2] 

机构地区：[1]中国三峡大学第一临床医学院,湖北宜昌市中心医院眼科443003 [2]中国广州中山大学中山眼科中心,510060

出　　处：《国际眼科杂志》2004年第2期338-340,共3页International Eye Science

摘　　要：目的:观察显微镜联合三面镜直视下,不借助导光纤维,施行巩膜外顶压并冷凝手术治疗孔源性视网膜脱离的疗效并评估临床应用的可能性。方法:孔源性视网膜脱离46例全部应用了显微镜联合角膜前置镜或三面镜直视下巩膜外顶压及冷凝的手术方法,并记录了术前增殖性视网膜病变(PVR)、玻璃体混浊和术后早期瞳孔区渗出、冷凝区反应等情况。先做巩膜外垫压和/或环扎带预置缝线,在手术显微镜下切开巩膜和脉络膜引流视网膜下液,然后用冷凝头顶压巩膜直视下确定裂孔及变性区的部位,并冷凝。最后完成巩膜外垫压和/或巩膜环扎术。在眼压低时,玻璃体内注入消毒空气。术后观察视力、眼压、早期瞳孔区渗出、冷凝区反应、视网膜复位情况。结果:所有病例脱离的视网膜完全复位,矫正视力在0.3以上的有14眼。术后瞳孔区和冷凝区视网膜均无过度炎性及冷凝反应。结论:显微镜直视下巩膜外顶压并冷凝治疗孔源性视网膜脱离手术具有简单、方便、快捷的特点,疗效可靠。AIM: To observe the effect of indentation combined with cryoretinopexy in treating rhegmatogenous under surgical microscope, and to assess the possibility of clinical application. · METHODS: A total of 46 cases of rhegmatogenous retinal detachment underwent indentation combined with cryoretinopexy. Firstly, suture was preplaced by buckling and/or circling. Then subretinal fluid was drained away with sclerotomy and choroidotomy under surgical microscope and the location of retinal breaks and degenerations were determined with scleral indentation and cryoretinopexy through sclera. Finally, buckling and/or circling were performed. At the end of the surgery, filtered air was injected into the vitreous cavity if necessary. Visual acuity, intraocular pressure, early effusion in papillary zone, and the condition of retinal reattachment were observed during the follow-up.· RESULTS: All the patients got complete retinal reattachment. The corrected visual acuity was better than 0.3 in 14 eyes. No excessive inflammation or condensation occurred after surgery.· CONCLUSION: Indentation combined with cryoretinopexy under surgical microscope is simple, convenient and quick to perform. Thus the curative effect is reliable.·

关 键 词：显微镜 巩膜外顶压 冷凝疗法 孔源性视网膜脱离 临床研究 三面镜 

分 类 号：R779.6[医药卫生—眼科]