巩膜扣带术中应用显微镜直视下裂孔定位65例

Locating retinal holes under a microscope in scleral buckling surgeries in 65 cases

目的:探讨显微镜直视下裂孔定位法在巩膜扣带术中定位和封闭视网膜裂孔的疗效。方法:2000/2004年的住院孔源性视网膜脱离,随访超过2mo的患者65例65眼。通过手术显微镜巩膜顶压作裂孔定位,冷凝。根据术前设计分别行环扎+巩膜外加压,或巩膜外加压。结果:术后65例65眼视网膜裂孔均位于手术嵴上,裂孔封闭好。出院后3例视网膜脱离复发,经二次手术后视网膜复位。65例65眼术后视力均有不同程度的提高。并发症有高眼压4眼,视网膜脱离复发3眼。一次手术成功率是95%。随访2mo以上,最佳矫正视力≥1.0的8眼,≥0.8并<1.0的5眼,≥0.5并<0.8的16眼,≥0.3并<0.5的9眼,≥0.1并<0.3的20眼,≥0.05并<0.1的6眼,<0.05的1眼。结论:显微镜直视下裂孔定位法定位、封闭裂孔准确、操作简单、效果好。

AIM： To evaluate the clinical effect of location and closure of retinal holes under a microscope in scleral buckling surgeries.METHODS： Sixty-five patients （65 eyes） were diagnosed as retinal detachment （RD） in wards from 2000 to 2004 and were followed up for more than 2too. The location and cryopexy of the retinal holes were made by scleral temponade under a microscope. According to the preoperational design, patients received scleral circling＋buckling sugeries, or only scleral buckle operation. RESULTS： Retinal holes were well closed and located on the surgical buckle in all the 65 eyes post the primary surgery, but RD recurred in 3 eyes and the retinal reattachment was achieved after the secondary operation.The one-operation success rate was 95.4%. The visual acuity in 65 eyes of the 65 patients post operation was enhanced in different degrees. Complications included ocular hypertension in 4 eyes and RD recurrence in 3 eyes. After 2-mo follow-up, the best corrected visual acuity was ≥1.0 in 8 eyes, ≥0.8 and 〈1.0 in 5 eyes, ≥0.5 and 〈0. 8 in 16 eyes, ≥10.3 and 〈0.5 in 9 eyes, ≥0.1 and 〈0.3 in 20 eyes, ≥10.05 and 〈0.1 in 6 eyes, and 〈0.05 in 1 eye. CONCLUSION： The location and closure of retinal holes under a microscope is accurate, simple and effective.