松解性视网膜切开及切除联合硅油填充术治疗复杂性视网膜脱离

Relaxing Retinotomy and Retinectomy Combined with Silicone Oil Tamponade for Complicated Retinal Detachment

目的探讨一种行之有效的治疗复杂视网膜脱离的手术方法。方法增殖性玻璃体视网膜病变（ｐｒｏｌｉｆｅｒａ－ｔｉｖｅｖｉｔｒｅｏｒｅｔｉｎｏｐａｔｈｙ，ＰＶＲ）Ｄ３级患者１８例，行闭合式玻璃体切割，环扎，松解性视网膜切开及切除联合硅油填充术，个别病例同时行前节再造，人工晶体取出及穿透性角膜移植术。结果视网膜完全复位１３例（７２．２％）；视力较术前增加９例（５０．０％），矫正视力低于０．０２者６例（３３．３％），０．０２～０．０５者９例（５０．０％），高于０．０５者３例（１６．７％）；大于１８０°视网膜切开７例，视力在０．０５以上者２例（２８．６％），３６０°切开及切除３例，视网膜复位２例，视力均低于０．０２。结论松解性视网膜切开及切除联合硅油填充可以作为治疗复杂性视网膜脱离的一种手术方法。

ObjectiveTo explore an effective approach to treat complicated retinal detachment.Methods18 eyes of consecutive cases with severe(proliferative vitreoretinopathy,PVR)were reviewed in this study. In all the cases, retinotomy or retinectomy or both were performed, combined with silicone oil tamponade. We performed anterior segment restoration,penetrating keratoplasty,and posterior chamber intraocular lens removed in some cases.ResultsRetina was reattached in 13 eyes( 72.2% ); visual acuity was improved in 9 eyes(50.0%); lower than 0.02, 6 eyes(33.3%);0.02 0.05, 9 eyes(50.0%); higher than 0.05, 3 eyes(16.7%). Seven of the cases with retinectomy more than 180° got a visual acuity higher than 0.05 (28.6%). Of the three cases with 360° retinectomy,retina reattached in two,but visual acuity was lower than 0.02.ConclusionRelaxing retinotomy and retinectomy combined with silicone oil tamponade may be a surgical means of treating complicated retinal detachment.