玻璃体手术联合黄斑裂孑乙光凝治疗高度近视黄斑裂孔性视网膜脱离

Vitrectomy associatied with photocoagulation to macular hole to treat retina detachment caused by macular hole in highly myopic eyes

目的探讨高度近视黄斑裂孔性视网膜脱离玻璃体手术中行黄斑裂孔光凝的适应证及手术技巧并评价治疗效果。方法选择21例高度近视黄斑裂孔性视网膜脱离患者，行常规经平坦部玻璃体切除、重水下行黄斑裂孔激光光凝、气-液交换、C3F8填充玻璃体腔，术后保持头低位，随访1～6个月。结果18例术后视网膜全部复位，3例气体吸收后视网膜脱离复发；术后视力提高者16例，不变者2例，下降者3例。结论对于某些高度近视黄斑裂孔性视网膜脱离，行玻璃体手术，并在手术中行激光封闭黄斑裂孔能够到达复位视网膜、防止视网膜脱离复发的目的。

Objective To investigate the indication and operative skill and clinical effect of vitrectomy associatied with photocoagulation to macular hole to treat retina detachment caused by macular hole in highly myopic eyes.Methods A total of 21 highly myopic eyes with retina detachment caused by macular hole were received vrtrectomy.During surgery, perfluorodecalin were injected in the macular hole, photocoagulation to macular hole, gas-liquid exchange and filled vitreous with 14%C3F8 were carried out in following steps. Keep head down after surgery.The follow up duration was 1 to 6 months.Results The retina of all of these 21 eyes was reattached.Macular hole were not adhered firmly in 3 eyes and retina re-detached when gas were absorbed.Visual acuity were improved in 16 eyes, unchanged in 2 eyes and decreased in 3 eyes.Conclusions The surgery of vitrectomy associatied with photocoagulation to macular hole can effectively treat retina detachment caused by macular hole in highly myopic eyes.