高度近视黄斑裂孔性视网膜脱离的玻璃体手术疗效观察

Observation of the efficacy ofvitreoretinal surgery for retinal detachment with macular hole caused by high myopia

目的 研究玻璃体视网膜手术对高度近视黄斑裂孔性视网膜脱离的疗效及手术并发症.方法 回顾性分析2009年4～9月连续住院诊断为高度近视黄斑裂孔性视网膜脱离的病例,共17例17只眼,其中男6例,女11例.手术采用玻璃体切除联合长效气体或砖油充填术,术后患者保持头低位7～14d,术后随访1～6月,平均4个月.结果 黄斑裂孔闭合,视网膜解剖复位15只眼（88.2%）.术后视力提高13只眼（76.5%）,无变化2只眼.结论 玻璃体视网膜手术术中松解玻璃体牵引,剥除黄斑前膜,联合膨胀气体或硅油填充,提高了高度近视黄斑裂孔性视网膜脱离手术成功率.

Objective To investigate the efficacy ofvitreoretinal surgery for retinal detachment with macular hole caused by high myopia and surgical complication. Methods A total of 17 patients （17 eyes）with retinal detachment of macular hole caused by high myopia underwent vitrectomy from Apr. 2009 to Sep.2009 were analyzed retrospectively. Of 6 cases were male while 11 cases were female. The pars plana vitrectomy with long acting gas of silicon oil tamponade was used. After the surgery, the patients were kept lying face down at least 7-14 days. The follow-up ranged from 1 to 6 months （4 months in average）. Results Macular hole closed in 15 cases, retina reattached in 15 out of 17 eyes （88.2%）. Postoperative visual acuities of 13 eyes（76.5%） were improved while the other 2 eyes ofmacular hole did not change after surgery. Conclusions Vitreoretinal surgery can relax vitreous traction, peel preretinal membrane. The therapy of vitrectomy combined with C3F8 or silicon oil tamponade is safe and available to cure retinal detachment of macular hole caused by high myopia and increase the rate of success.