原发性视网膜脱离的手术选择

Choice of surgical procedures for treatment of primary retinal detachment

原发性视网膜脱离手术治疗的发展历史经过了80多年,目前可选择的手术方式,包括在巩膜外进行放液的环扎术、仅限于裂孔部位的节段性垫压术,以及侵入眼内的注气手术和玻璃体切除术。这几种术式,都可能获得较高的视网膜脱离复位率,但在手术的花费、并发症以及长期视力等方面存在差别。无论选择何种术式,封闭引起漏水的裂孔,仍是手术的基本目的。因此,应该在手术之前仔细寻找所有裂孔,然后根据病例首选手术量较小而且可能一次成功、并发症少、视力后果好、花费少的术式。

More than 80 years has elapsed in the history of primary retinal detachment surgery. The current options for treatment of primary retinal detachment include scleral encircling operation with drainage, segmental buckling limited to the area of retinal breaks, and intraocular approach of gas injection and vitrectomy. Those operations all can achieve high percentage of retinal reattachment, however, differences among those operation still exist in the cost, complications, and long-term visual outcomes. No matter which operation is chosen, sealing the leaking breaks is the principle ride. It is recommended, therefore, that all breaks be carefully found before operation and that surgery with minimal manipulation, less complication, better visual outcome, lower cost and success with one operation be chosen as primary surgery based on case selection.