伴有后巩膜葡萄肿黄斑裂孔性视网膜脱离的手术选择

Outcome of vitreous surgery for macular hole retinal detachment in eyes with posterior staphyloma

目的 探讨伴有后巩膜葡萄肿黄斑裂孔性视网膜脱离手术方法及临床疗效。方法 回顾分析173例后巩膜葡萄肿黄斑裂孔性视网膜脱离的临床资料，按填充物的不同分别采用玻璃体切除，内界膜剥离，气体、硅油填充两组，比较其视网膜解剖复位率和视力的变化。结果 一次性视网膜解剖复位率：气体组为81．8％，硅油组为94．5％，两者比较差异有统计学意义（P〈0．05）；视力进步：气体组为54．5％，硅油填充组56％，两者比较差异无统计学意义（P〉0．05）；白内障发展需行手术：气体组为9％，硅油填充组12％。结论 伴有后巩膜葡萄肿黄斑裂孔性视网膜脱离应用玻璃体切除、内境界膜剥离、硅油填充可提高一次性视网膜解剖复位率。

Objective To observe the clinical effects and surgical outcome of retinal detachment （RD） caused by macular hole in eyes with posterior staphyloma. Methods The clinical materials of 179 eyes of posterior staphyloma with RD caused by macular hole were reviewed. All patients were underwent vitrectomy and inner limiting membrane peeling. According to different temponade, the cases were divided into silicone oil group and gas group. Postoperatively visual acuity and rate of retinal attachment were compared. Results The rates on anatomic attachment of retine were as follow： 81.8% in the gas group and 94.5% in the silicone oil group. There was siganificant difference between silicone oil group and gas group （p〈0.05）. The rates on visual acuity improved were 54.5% in gas group and 56% in silicone oil group. There was no siganificant difference between silicone oil group and gas group（p〉0.05）.There were 9% patients in gas group and 12% patients in the silicone oil group, whose cataract were develped and need surgical treament. Conclusions The vitrectomy combined with removal of inner limiting membrane and silicone oil tamponade is an effective and optimal procedure for RD caused by macular hole in eyes with posterior staphyloma.