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无放液最小量巩膜外加压术治疗孔源性视网膜脱离

闵寒毅 毛进 高斐 谭柯 贺峰 罗岩 于伟泓 陈有信 董方田

闵寒毅, 毛进, 高斐, 谭柯, 贺峰, 罗岩, 于伟泓, 陈有信, 董方田. 无放液最小量巩膜外加压术治疗孔源性视网膜脱离[J]. 协和医学杂志, 2011, 2(4): 357-361. doi: 10.3969/j.issn.1674-9081.2011.04.014
引用本文: 闵寒毅, 毛进, 高斐, 谭柯, 贺峰, 罗岩, 于伟泓, 陈有信, 董方田. 无放液最小量巩膜外加压术治疗孔源性视网膜脱离[J]. 协和医学杂志, 2011, 2(4): 357-361. doi: 10.3969/j.issn.1674-9081.2011.04.014
Han-yi MIN, Jin MAO, Fei GAO, Ke TAN, Feng HE, Yan LUO, Wei-hong YU, You-xin CHEN, Fang-tian DONG. Minimal Scleral Buckling without Sub-retinal Drainage for Rhegmatogenous Retinal Detachment: an Analysis of 30 Cases[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(4): 357-361. doi: 10.3969/j.issn.1674-9081.2011.04.014
Citation: Han-yi MIN, Jin MAO, Fei GAO, Ke TAN, Feng HE, Yan LUO, Wei-hong YU, You-xin CHEN, Fang-tian DONG. Minimal Scleral Buckling without Sub-retinal Drainage for Rhegmatogenous Retinal Detachment: an Analysis of 30 Cases[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(4): 357-361. doi: 10.3969/j.issn.1674-9081.2011.04.014

无放液最小量巩膜外加压术治疗孔源性视网膜脱离

doi: 10.3969/j.issn.1674-9081.2011.04.014
详细信息
    通讯作者:

    闵寒毅 电话:010-65296365, E-mail:wredge@sohu.com

  • 中图分类号: R774.1;R779.63

Minimal Scleral Buckling without Sub-retinal Drainage for Rhegmatogenous Retinal Detachment: an Analysis of 30 Cases

More Information
    Corresponding author: MIN Han-yi Tel: 010-65296365, E-mail:wredge@sohu.com
  • 摘要:   目的  探讨最小量巩膜外加压治疗孔源性视网膜脱离的疗效和并发症。  方法  回顾性分析北京协和医院单纯孔源性视网膜脱离采用无放液、最小量巩膜外硅海绵加压术治疗28例患者30只眼, 术前术后视力变化、视网膜复位情况及并发症。  结果  采用无放液、最小量巩膜外加压治疗的28例患者30只眼中巩膜外硅海绵加压缝合1针13只眼, 缝合2针14只眼(其中1只眼2个裂孔分开, 分别进行巩膜外加压1针), 缝合3针及以上3只眼。术前最佳矫正视力(best corrected visual acuity, BCVA) < 0.1为14只眼, 0.1~0.3为8只眼, > 0.3为8只眼。术后平均随诊(9.4±2.5)个月, 术后最佳矫正视力 < 0.1为5只眼, 0.1~0.3为9只眼, > 0.3为16只眼, 治疗前后视力比较差异有统计学意义(P < 0.05)。术后视网膜24 h内复位20只眼, 72 h内复位8只眼, 再次手术3只眼。一次性手术成功率90%, 二次成功率100%。发生巩膜外加压海绵外露1例。  结论  无放液、最小量巩膜外加压术是治疗单纯孔源性视网膜脱离的有效方法。
  • 图  1  间接镜下巩膜外视网膜裂孔冷冻

    视网膜裂孔(箭头),在冷冻头顶压下隆起,尖端呈灰白色冷冻斑

    图  2  单针巩膜外硅海绵加压

    A.术前孔源性视网膜脱离,圆形裂孔上方有盖(箭头); B.单针“8”字形巩膜外硅海绵加压; C.术后嵴高度不明显,但视网膜完全复位,激光封闭裂孔

    图  3  马蹄形裂孔视网膜脱离

    A.术前示马蹄形裂孔(箭头); B.术中经线方向缝合2针; C.术后见嵴范围小,较高,裂孔位于嵴上,裂孔周围激光斑

    图  4  多个视网膜裂孔性视网膜脱离

    A.下方视网膜脱离区内3个裂孔(箭头); B.最小量弧形加压后,嵴较高,视网膜复位,激光封闭裂孔

    表  1  孔源性视网膜脱离患者最小量巩膜外加压术前后视力变化

    时间 视力(只眼)
    <0. 1 0. 1 ~ 0. 3 >0. 3/s
    术前 14 8 8
    术后 5 9 16
    x2 6. 9886
    P 0. 03
    下载: 导出CSV
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    [9] William JF, Nadia D, Saurabh YJ, et al. The fluid mechanics of scleral buckling surgery for the repair of retinal detachment[J]. Graefes Arch Clin Exp Ophthalmol, 2010, 248:31-36. doi:  10.1007/s00417-009-1198-z
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出版历程
  • 收稿日期:  2010-07-27
  • 刊出日期:  2011-10-30

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