玻璃体视网膜手术联合脉络膜上腔引流术治疗视网膜脱离合并脉络膜脱离

Vitreoretinal surgery combined with suprachoroidal space drainage through sclerocentesis for treatment of retinal and choroidal detachment

目的:探讨视网膜脱离合并脉络膜脱离的手术治疗方法、手术时机并观察疗效。方法:总结、分析2000-02/2005-02间因视网膜脱离合并脉络膜脱离在我院接受手术治疗的连续患者共36例36眼,其中原发性孔源性视网膜脱离合并脉络膜脱离30例,复发性视网膜脱离合并脉络膜脱离6例。手术方法包括巩膜外环扎、经巩膜穿刺口脉络膜上腔引流、玻璃体视网膜手术、眼内光凝、硅油或C3F8填充术等。结果:36只患眼于术中成功引流脉络膜上腔液体。硅油填充30眼、C3F8填充6眼,视网膜脉络膜全部复位、视网膜裂孔封闭。36眼术后视力为手动至0.3,其中26例术后视力≥0.1。结论:玻璃体视网膜显微手术联合经巩膜穿刺口脉络膜上腔积液引流术是处理脉络膜脱离合并视网膜脱离的有效手术方法。

AIM： To evaluate the surgical techniques, the efficacy and operation time for treatment of retinal and choroidal detachment. METHODS： We reviewed and analyzed the operative effects of vitreoretinal surgeries in 36 patients （36 eyes） with retinal and choroidal detachment in our hospital from February, 2000 to February, 2005. In these 36 eyes, there were 30 eyes of rhegmatogenous retinal detachment associated with choroidal detachment, 6 eyes of retinal redetachment associated with choroidal detachment. The surgical techniques include scleral encircling operation, epichoroidal space drainage by sclerocentesis, intraocular photocoagulaton, gas-fluid exchange or silicone oil intraocular tamponade and vitreoretinal surgery. RESULTS： The drainage of the suprachoroidal space liquid and blood was successful in 36 eyes. Silicone oil tamponade was performed for 30 eyes and C3F8 tamponade for 6 eyes. Retinas and choroids were all reattached and retinal holes were closed. The mean follow-up time was 6. 8 months. Visual acuities were improved, ≥0.1 in 26 eyes. CONCLUSION： The vitreoretinal surgery and external drainage by sclerocentesis is an effective operating method for rhegmatogenous retinal detachment associated with choroidal detachment.