高度近视LASIK前孔源性局限性视网膜脱离的处理

Treatment of Rhegmatogenous Limited Retina Detachment in high myopia eyes before Lasik

目的探讨高度近视眼LASIK术前孔源性局限性视网膜浅脱离的处理方法。方法将拟行LASIK手术的高度近视合并孔源性局限性视网膜浅脱离患者32例32只眼，根据治疗方法不同分为3组，分别行单纯激光光凝、冷凝联合巩膜外加压和光凝联合巩膜外加压治疗，随访观察3～6月，分析其疗效及相关并发症。结果单纯激光光凝组治疗的有效率最低；冷凝联合巩膜外加压组治疗的有效率最高，但部分患者术后玻璃体混浊情况较术前加重；光凝联合巩膜外加压组治疗术后玻璃体混浊改变情况优于冷凝联合巩膜外加压组。结论冷凝联合巩膜外加压仍是目前治疗高度近视眼LASIK术前孔源性局限性视网膜浅脱离疗效最确切的方法，单纯激光光凝或光凝联合巩膜外加压，是值得进一步研究的有效的替代手段。

Objective To investigate the treatment of rhegmatogenous limited retina detachment in high myopia eyes before Lasik. Methods 32 cases（32 eyes） were divided to 3 groups. Theses cases were treated by laser photocoagulation, cryosurgery combined with scleral buckling and photocoagulation combined with scleral buckling. The treated eyes were followed from 3 to 6 months after therapy. The effective rate and complication of these methods were analyzed. Results The effective rate of laser photocoagulation is the poorest. The effective rate of cryosurgery combined with scleral buckling was the highest. However, the postsurgery condition of vitreous opaticy was worse than presurgery. Compared with cryosurgery group, the change of vitreous opaticy of photocoagulation combined with scleral buckling was better. Conclusion cryosurgery combined with scleral buckling is the most effective method to treat rhegmatogenous limited retina detachment, laser photocoagulation and photocoagulation combined with scleral buckling are the substitutive methods which need more study.