外路显微镜直视下手术治疗孔源性视网膜脱离的临床观察

Clinical Observation of External-route microsurgery in the Treatment of Rhegmatogenous Retinal Detachment

目的:观察显微镜直视下经外路手术治疗孔源性视网膜脱离的临床疗效。方法:孔源性视网膜脱离38例(38眼),术前在三面镜下检查裂孔位置、大小及脱离范围;在手术显微镜直视下行裂孔及变性区定位,放出视网膜下液,在裂孔及周围行视网膜冷凝,作硅胶垫压及环扎带。最后顶起硅胶垫压块,证实裂孔位于巩膜脊前坡上,视裂孔位置及眼压情况,玻璃体腔内注入C3F8。术后观察视力、眼压、葡萄膜反应及视网膜复位情况。结果:视网膜裂孔封闭36眼(94.74%),视网膜完全复位34眼(89.47%),视网膜下积液2眼(5.26%),于7～10d吸收。有2眼术后发现垫压嵴偏离视网膜裂孔,经再次手术调整后视网膜复位。术后视力提高28眼(73.68%)。结论:显微镜直视下经外路视网膜脱离手术视野清晰,操作简便,手术效果良好。

Objective： To observe the clinical efficacy of external-route microsurgery in the treatment of rhegmatog enous retinal detachment. Methods： Thirty-eight patients （38 eyes） of Rhegmatogenous retinal detachment, which were examined of location, size and scope of holes using the three-mirror contact lens before surgery, were performed external-route microsurgery. The visual acuity, intraocular pressure, retina were observed after surgery. Results： The （94.74%）, completely reattachment of retina 34 sorbed in 7 - 10 days, and improvement of visual data were collected retinal uveal reaction as following： closure and the reattachment of of retinal tears 36 eyes eyes （89.47%）, subretinal fluid 2 eyes （5. 26%）, which were abacuity after surgery 28 eyes （73.68o/6o）. Among those, there were 2 eyes pad pressure ridge departures from the retinal hole, which were adjusted by reoperation. Conclusion： External route microsurgery for rhegmatogenous retinal detachment is clear, convenient and effective.