手术显微镜下视网膜脱离外路手术的体会

External-route microsurgery for retinal detachment

目的探讨手术显微镜直视下行视网膜裂孔的定位，冷凝在视网膜脱离的外路手术中的应用及其效果。方法对裂孔源性视网膜脱离92例（92眼），在手术显微镜下进行手术。先预置硅胶带和（或）环扎带，然后进行裂孔的定位，冷凝，放液，检查裂孔位置和眼内注气。结果手术显微镜直视下进行裂孔定位，裂孔清晰不易遗漏，视网膜冷凝反应清晰可见，无严重手术并发症，一次手术视网膜复位83眼，再次手术视网膜复位5眼，最终视网膜复位率95．65％，视力≤0．1者18眼，占19．56％，视力〉0．1～0．4者40眼，占43．48％，视力≥0．5者34眼，占36．96％。结论在手术显微镜下进行视网膜脱离的外路手术是一种易于掌握，疗效确切的手术方式。

Objective To search the methed, clinal effect of visible cryocoagulation by surgical microscope in external detachment surgery. Methods In 92 patients（92eyes） with rhegmatogenous RD, the silica gelpiece and/or buckling bands were preplaced, and drainage of subretinal fluid, retina lcryotherapy, examination of locating the holes, and intraocular injeetive of gas were performed under surgical microscope. Results Under the surgical microscope, the orientation of the holes and the reaction of retinal eryotherapy were clearly visible without any serious surgical sequela. Retinal reattachment was achieved in 83 eyes after the primary surgery and in 5 eyes after the secondary surgery, with the final rate of reattachment of 95.65%. The best-corrected visual acuity was ≤0. 1 in 18 eyes（19. 56%）, 0. 1 -0.4 in 40 eyes （43.58%） ,and ≥0. 5 in 34 eyes（36.69% ）. Conclusion The exeternal-route micro-surgery is simple, convenient, reliable, and effective.