充气性视网膜固定术治疗单纯性孔源性视网膜脱离

Treatment of primary rhegmatogenous retinal detachment with pneumatic retinopexy

目的观察充气性视网膜固定术联合激光治疗单纯性孔源性视网膜脱离的疗效及其并发症。方法于2002年1月￣2004年6月,对24例单纯性孔源性视网膜脱离眼行充气性视网膜固定术病例进行回顾性分析,观察视力、视网膜复位率及PVR变化。结果24例24眼,随访至少6月,平均7.5个月,经一次眼内充气性视网膜固定术,视网膜复位18例占75%(18/24),2例行多次眼内注气术视网膜完全复位,充气性视网膜固定术总的视网膜复位率达83%(20/24)。4例需要再次手术,3例由于眼内注气术后出现视网膜新裂孔改行巩膜扣带术获得视网膜复位,1例因为PVR发展行玻璃体切割手术视网膜复位。最终视网膜复位率达100%。术后视力较术前视力明显提高。结论充气性视网膜固定术是治疗某些单纯性孔源性视网膜脱离的一种有效方法,该手术具有简便、易行、耗时少,费用少,术后并发症少等优点。

To report the visual results and complications of an intravitreal injection of expending gas in combination laser photocoagulation of retinal tears in the therapy of primary rhegmatogenous retinal detachment. During the period of January 2002 to June 2004, 24 consecutive cases of with pneumatic retinopexy (PR) in the therapy of primary rhegmatogenous retinal detachment were retrospectively reviewed. Postoperative primary and final anatomical outcome, visual acuity, and complications was analyzed. Patients were followed for a minimum of 6 months (mean, 7.5 months). The reattachment after single PR operation was 75% (18/24 eyes), 2 cases required multiple injection of the gas, The total reattachment after PR operation was 83%(20/24); 4 of cases in17 % (4/24 eyes)reoperation was needed. 3 cases with new retinal breaks developed in retina required an additional scleral buckling to achieve final anatomic success. One case with initiation and acceleration of proliferative vitreoretinopathy(PVR) was needed pars plana vitrectomy with tamponading the vitreous cavity by gas . Final reattachment was obtained in 24 of 24 (100%) patients. Postoperative visual acuity is also a significant improvement. [Conclutions] Pneumatic retinopexy is an effective surgery for certain types of rhegmatogenous retinal detachment. Pneumatic retinopexy is a quite modest and time-saving and costs less operative technique. Postoperative complications of PR are rare.