视网膜脱离外路显微手术的临床观察

External-route microsurgery for retinal detachment

目的 观察视网膜脱离外路显微手术的临床效果。 方法 对 36例简单孔源性视网膜脱离患者的 36只患眼 ,先预置硅胶块和 (或 )环扎带 ,然后在手术显微镜直视下完成排视网膜下液、视网膜冷凝 ,检查裂孔位置和眼内注气。并与同期 37例裂孔性视网膜脱离患者间接检眼镜下手术结果进行比较。 结果 手术显微镜直视下患眼视网膜冷凝反应均清晰可见 ,轻度屈光间质混浊并不影响观察冷凝反应和裂孔定位 ,无严重手术后遗症。 1次手术后视网膜完全复位 31只眼 ,再次手术后视网膜复位 3只眼 ,最终视网膜复位率 94 %。视力 <0 .1者 6只眼 ,占 16 .7% ;0 .1～ 0 .4者 15只眼 ,占 4 1.7% ;≥ 0 .5者 15只眼 ,占4 1.7%。和常规间接检眼镜下视网膜脱离手术具有相同的手术效果。 结论 视网膜脱离外路显微手术具有操作简单、方便 。

Objective To observe the clinical efficacy of external -rou te microsurgery for retinal detachment (RD). Methods In 36 patie nts (36 eyes) with single rhegmatogenous RD, the silica gel piece and/or bucklin g bands were preplaced, and drainage of subretinal fluid, retinal cryotherapy, e xamination of locating the holes, and intraocular injection of gas were performe d under surgical microscope. The surgical effects were compared with those of ot her simultaneous 37 patients with rhegmatogenous RD who underwent surgery under binocular indirect ophthalmscope. Results The simultaneous int raoperative observation of the fundus details and the sclera through the microsc ope was excellent in all cases. Under the surgical microscope, the reaction of r etinal cryotherapy was clearly visible without any serious surgical sequela. The observation of reaction of retinal cryotherapy and the orientation of the holes were not affected by mild opacity of the refractive media. Retinal reattachment was achieved in 31 eyes after the primary surgery and in 3 eyes after the secon dary surgery, with the final rate of reattachment of 94%. The best-corrected vi sual acuity was <0.1 in 6 eyes (16.7%), 0.1-0.4 in 15 eyes (41.7%), and ≥ 0.5 in 15 eyes(41.7%). The results were similar to those of the patients underwent surgery under indirect ophthalmoscope. Conclusion The external -route microsurgery is simple, convenient, reliable, and effective.