巩膜扣带术治疗原发性非增生性视网膜脱离

Scleral buckle for the treatment of rhegmatogenous retinal detachment

目的观察巩膜扣带术治疗原发性(孔源性)非增生性视网膜脱离的疗效。方法36例(36眼)行巩膜扣带术。均按我们提出的视网膜脱离手术的3项要求(准确的裂孔定位,适度的冷凝和恰当的放置外垫压物)进行手术。术后随访,观察视网膜复位情况,视力、眼压及并发症。结果视网膜复位30眼(83.33%),失败6眼(16.67%),失败原因:1眼发生鱼嘴现象,3眼裂孔封闭不良,2眼垫压偏位。术后视力提高33眼,不变2眼,下降1眼。眼压升高3眼,服药后恢复正常。垫压物松动,环扎带移位及冷凝过度各1眼。结论巩膜扣带术治疗非增生性原发性视网膜脱离简单可靠。应用间接检眼镜直视下手术可大大提高手术成功率。

Objective To investigate the effect of scleral buckle on rhegmatogenous reinal detachment. Methods 36 cases(36 eys) of rhegmatogenous retinal detachment were treated with scleral buckle,and the surgery included accurate localizaiton of tears,cryotherapy and inserting scleral buckle properly.Retina reattachment,visual acuity,intraouclar pressure(IOP) and complications were observed after the surgery. Results 30 eyes(83.33%) achieved retina reattachment,and 6 eyes (16.67%) of retinal detachment were not replaced.The causes of failure were:1 eye of fish-mouth like phenomenon,3 eyes of retinal tears were not closed fully,and 2 eyes of scleral buckles moved.Visual acuity improved in 33 eyes,unchanged in 2 eyes and fell in 1 eye.IOP increased in 3 eyes and became normal after medicine therapy. Conclusion Sclearal bulkle on rhegmatogenous retinal detachment is simple and reliable.Accurate tears localization with binocular indirect ophthalmoscope can increase successful rate.