视网膜造孔处理无裂孔视网膜下增生牵引性视网膜脱离

Retinotomy using in tractional nonrhegmatogenous retinal detachment with subretinal strands

目的观察视网膜造孔取出视网膜下增生膜后，视网膜脱离的复位、造孔愈合及远期视网膜稳定性。方法3例无裂孔视网膜下增生牵引性视网膜脱离，进行视网膜造孔取出视网膜下增生膜、造孔处眼内激光光凝封闭及玻璃体腔硅油填充。结果3例（3眼）手术后视野扩大、视力不同程度提高。2周后造孔激光光斑处色素游离。1年后硅油取出，视网膜稳定。结论视网膜造孔取出视网膜下膜，是处理视网膜下增生牵引性视网膜脱离的较好方法，对视网膜损伤较小、脱离视网膜复位有效，但视力的恢复取决于视网膜本身条件。手术操作过程中应避开黄斑区域。

Objective To observe the cure of the retinotomy incision, flatness and stability of the retina in long duration after removing subretinal strands through retinotomy in chronic retinal detachment. Methods The subretinal strand was removed through retinotomy in 3 cases of nonrhegmatogenous retinal detachment, the retinal hole was closed by endolaser photocoagulation, and silicone oil tamponade was performed. Results In the 3 cases, the vision and visual field was improved after surgery. Pigmentation of the retina around retinotomy appeared 2 weeks later. The retina was stable when the oil was removed one year after surgery. Conclusion Small retinotomy is an effective method to remove subretinal strands. The vision recovery is based on the retinal function. Macular damage should be avoid during the surgery.