显微镜直视下眼内光凝联合巩膜外冷凝治疗复杂性视网膜脱离

Intraocular photocoagulation combined with transcleral cryotherapy under operation microscope for complicated retinal detachment

目的探讨应用玻璃体切割术且眼内光凝联合显微镜直视下巩膜外冷凝视网膜裂孔,治疗复杂性视网膜脱离的手术效果。方法复杂性视网膜脱离患者42例(42眼)均行玻璃体切割术、显徽镜直视下光凝裂孔联合冷凝视网膜。术后检查视力、眼压、并发症情况等。术后所有患者均随访6～36个月,平均25.3个月。结果一次手术治愈36例(85.7%),3例(7.1%)为二次手术后治愈,治愈率92.9%。术后盲目率为26.2%,与术前盲目率81.0%相比显著下降(χ2=25.320,P<0.001)。术后玻璃体出血2眼(4.8%),高眼压8眼(19.0%)。结论应用玻璃体切割术且眼内光凝联合手术显微镜直视下巩膜外冷凝视网膜裂孔,治疗复杂性视网膜脱离疗效可靠,有重要的临床应用价值。

Objective To investigate the therapeutic efficacy of vitrectomy,intraocular photocoagulation combined with transcleral cryotherapy on retinal hole under operation microscope for complicated retinal detachment.Methods A total of 42 cases（42 eyes）with complicated retinal detachment were underwent vitrectomy,intraocular photocoagulation on slit pore combined with transcleral cryotherapy on retina under operation microscope.Visual acuity,intraocular pressure and complications were examined postoperatively.All patients were followed up for 6 months to 36 months,averaged in 25.3 months.Results About 36 cases（85.7%）were cured after the initial surgery,and achieved completely retinal reattachment.About 3 cases（7.1%）achieved complete retinal reattachment after the second surgery.About 39 cases（92.9%）were with retinal hole closed,complete retinal reattachment.Postoperative blind rate was 26.2% obviously lower than 81.0% at pre-operation（χ2=25.320,P0.001）.There were 2 eyes（4.8%）with vitreous hemorrhage and 8 eyes（19.0%）with ocular hypertension postoperatively.Conclusion Vitrectomy,intraocular photocoagulation combined with transcleral cryotherapy on retinal hole under operation microscope for complicated retinal detachment is with favorable efficacy and important clinical application value.