彩色多普勒超声对巩膜扣带术后患者眼血流动力学的跟踪观察

Follow-up observation of ocular hemodynamics after scleral buckling with color Doppler flow imaging

目的观察孔源性视网膜脱离患眼在接受环扎加压术后远期眼部血流动力学的改变。方法应用Siemens Se- quia 512彩色多普勒超声诊断仪分别测定31例患者患眼与对侧眼的眼动脉、视网膜中央动脉、睫状后短动脉的收缩期最大血流速度、舒张末期血流速度、阻力指数,以对侧眼为对照组,分别对术后1～2年及术后3～4年患者的上述指标进行对照分析。结果术后1～2年组患眼的眼动脉、视网膜中央动脉、睫状后短动脉的各项血流动力学指标与对侧眼相比差异无统计学意义(P>0.05)。术后3～4年组患眼的视网膜中央动脉、睫状后短动脉的收缩期最大血流速度及舒张末期血流速度值均显著降低(P<0.05),阻力指数与眼动脉的各项测值患眼与对照组比较差异无统计学意义。术后各眼均未发生眼部缺血症状,视力恢复理想。结论环扎加压术后1～2年患眼的视网膜与脉络膜血供无明显变化,而在术后3～4年血供有减低趋势。环扎加压术可能会增加患眼远期的亚临床缺血症状。

Objective To observe the hemodynamic changes in the eyes of patients with rhegmatogenous retinal detachment after the scleral buckling procedure.Methods Siemens Sequia 512 color Doppler imaging was used to measure the velocity in the ophthalmic artery（OA）,central retinal artery（CRA）and short posterior ciliary artery（SPCA）of both eyes in 31 pa- tients with unilateral rhegmatogenous retinal detachments after the scleral buckle repair.Peak systolic velocity（V_（max））,end- diastolic velocity（V_（min））and resistance index（RI）of these arteries were measured.Contralateral eyes served as controls.Re- sults No significant difference was found in above indexes of the group of one to two years after surgery between binocular （P〉0.05）.V_（max）and V_（min）of CRA and SPCA from the group of three to four years after surgery showed significant reduction （P〈0.05）,but there were no significant difference in RI and indexes of OA between bilateral eyes（P〉0.05）.Ocular is- chemic syndrome was not found and visual improvement was achieved.Conclusion Retinal and choroidal blood flow do not change from one to two years after scleral buckling procedure,but there is a decreasing tendency from one to two years after surgery.Scleral buckling procedure can cause subclinical disturbance of the long-term choroidal circulation.