手术显微镜直视下外路治疗孔源性视网膜脱离的临床观察

External-route microsurgery for retinal detachment

目的探讨经显微镜直视下外路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136例(136眼)由同一术者进行外路手术,均在术中应用手术显微镜进行裂孔定位、冷凝封闭及巩膜外垫压。定期观察术后视力、眼内反应和视网膜复位情况。结果经显微镜直视下外路手术患者,术后随访1～6个月,视网膜完全复位125只眼(91.9%),视力较术前提高120只眼(88.2%),不变8只眼,下降8只眼。最好矫正视力0.3以上95只眼(69.8%)。术后所有患者视网膜冷凝反应Ⅰ～Ⅱ级,无Ⅲ～Ⅳ级。轻度屈光介质浑浊不影响手术过程。结论经手术显微镜直视下外路治疗孔源性视网膜脱离安全有效、简单可行,值得推广。

Objective To observe the clinical efficacy of external-route microsurgery for retinal detachment. Methods In 136 patients （ 136 eyes） with single rhegmatogenous RD were performed external-route microsurgery by the same doctor. All ea- ses modified retinal detachment surgery observed straightly through microscope. The visual acuity , retinal uveal, reaction and the reattachment of reinal were observed after surgery. Results After 1 -6 months, 125 of 136 eyes were repaired completely with a repairment rate of 91.9%. Visual acuity were improved in 88.2% （ 120 of 136 ） of the total eyes. The corrected acuity was better than 0. 3 in 95 eyes （69. 8% ）. The reaction of retinal cryotherapy after surgery in all cases were Ⅰ grade to Ⅱ grade. The observa- tion of reaction of retinal eryotherapy and the orientation of the holes were not affected by mild opacity of the refractive media. Conclusion The external-route mierosurgery is simple,convenient,reliable,and effective.