摘要
目的观察手术显微镜下最小量节段性巩膜外垫压术的临床疗效。方法对38例(38只眼)非复杂性孔源性视网膜脱离行最小量节段性巩膜外垫压术。所有手术步骤,包括裂孔定位与冷凝皆在手术显微镜下完成,不放视网膜下液而通过前房穿刺软化眼球。根据裂孔的位置,采用经修剪过的硅胶海绵块进行节段性外加压。无一例采用环扎。术后随访3～12个月。结果手术显微镜直视下视网膜裂孔及冷凝反应均清晰可见,一次手术视网膜完全复位35只眼(92.1%),手术中没有发生巩膜穿通及眼内出血等术中并发症,术后反应轻微,无一例增生性玻璃体视网膜病变(PVR)加重。末次随访矫正视力在0.3以上者21只眼,0.1～0.3者11只眼,小于0.1者6只眼;最终视力提高29只眼,不变7只眼,下降2只眼。结论手术显微镜下节段性巩膜外垫压术操作精细、简单方便,直视下视野清晰、裂孔冷凝、定位可靠且提高了手术效率;而以最小量手术为原则确保了手术创伤小、并发症少、术后恢复快,两者的有机结合是一种值得推荐的手术方法。
Objective To observe the clinical effect of minimal segment buckling for rhegmatogenons retinal detachment under operating microscope. Method 38 patients （ 38 eyes） with rhegmatogenous retinal detachment were enrolled in this study. All parts of surgery including localization and cryotherapy of the retinal break were performed under the operating microscope. Paracentesis of anterior chamber was applied to decrease IOP instead of drainage of subretinal fluid. According to the size and shape of the break, a silicone sponge was placed episcleral by one or two pair of suture to create a seleral buckle. Multiple retinal breaks in different quadrants were supported by separate scleral buckle. The scleral encircling was used in no eyes. All patients were followed up for 3 - 12 months. Results The retinal break and the reaction of retinal cryotherapy were seen clearly under the operating microscope in all cases. Retinal reattachment was achieved in 35 eyes of 38 eyes （92. 1% ） after the primary surgery. The best corrected visual acuity improved in 29 eyes, unchanged in 7 eyes, impaired in 2 eyes. Conclusion The minimal segment scleral buckling can reduce the complications of conventional buckling and maintain high success rat. Using operating microscope make the surgery refined, simple, convenient and effective.
出处
《临床眼科杂志》
2008年第6期533-535,共3页
Journal of Clinical Ophthalmology
关键词
视网膜脱离
手术显微镜
最小量
节段性巩膜外垫压术
Rrhegmatogenons retinal detachment
Operating microscope
Minimal surgery
Segment scleral buckling
