视网膜脱离手术前后黄斑部的光学相干断层扫描观察

Observation of macular changes before and after rhegmatogenous retinal detachment surgery

目的应用光学相干断层扫描观察孔源性视网膜脱离手术前后黄斑部的变化,分析后者与视功能的关系。方法回顾性分析单纯孔源性视网膜脱离患者68例68眼,手术前后均用光学相干断层扫描观察黄斑部的变化,所有患者为初次手术,PVRB、C1级,随访至少半年。其中38眼行巩膜外手术为A组,30眼行玻璃体手术为B组。结果光学相干断层扫描能精确显示黄斑部视网膜改变。A、B组手术后视力均显著提高(P<0.01),两组间差异无显著性(P>0.05)。A组的黄斑水肿、视网膜前膜发生率均高于B组。结论光学相干断层扫描是观察黄斑部视网膜复位的最客观指标,对于手术方法的选择有指导意义。

OBJECTIVE Using optical coherence tomography to observe the abnormality of macular before and after rhegmatogenous retinal detachment surgery and study the relationship between the abnormality and visual acuity. METHODS Sixtyeight cases（68 eyes）of rhegmatogenous retinal detachment were retrospectively reviewed, using optical coherence tomography to observe the abnormality of macular before and after surgery. All the patients underwent the first surgery, without other ocular diseases, PVR grade was B, C1. Thirtyeight eyes assigned to group A were operated with scleral buckling, 30 eyes assigned to group B were operated with vitrectomy. RESULTS Optical coherence tomography can precisely refract the changes of macular retinal tissue. The visual acuity after operation was improved prominently in both group A and B（P 〈0.01） ,and there was no difference between A and B（P 〉 0.05） .The incidence of macular edema and epiretinal membrane in group A was higher than in group B. CONCLUSIONS Optical coherence tomography is the most objective index to elevate the structm＇e of macular, which can guide us in choosing surgical proposals.