外路手术治疗复杂孔源性视网膜脱离疗效分析

The effect of scleral buckling surgery for complex rhegmatogenous retinal detachment

目的评价外路手术治疗复杂孔源性视网膜脱离的疗效及其相关因素。方法对73只眼随访资料完整的通过外路手术治疗的复杂孔源性视网膜脱离病例进行回顾性研究，其中单纯黄斑裂孔性视网膜脱离3只眼，巨大裂孔性视网膜脱离6只眼，人工晶状体眼视网膜脱离11只眼，伴有屈光间质混浊孔源视网膜脱离7只眼，多象限多发裂孔性视网膜脱离14只眼，裂孔不明性视网膜脱离6只眼，伴有P—PVRC3级的视网膜脱离8只眼，伴有脉络膜脱离的孔源性视网膜脱离6只眼，伴有黄斑裂孔的多发裂孔视网膜脱离12只眼。结果70只眼一次手术成功，视功能接近预期效果。3只眼未成功眼分别为黄斑裂孔眼和伴有脉络膜脱离眼。结论个性化的手术设计，精确的裂孔定位，合理的眼内填充是手术成攻的关键，会明显提高复杂孔源性视网膜脱离病例的外路手术成功率。

Objective To evaluate the effect and the related factors of scleral buckling surgery for complex rhegmatogenous retinal detachment. Methods Seventy-three eyes of complex rhegmatogenous retinal detachment with scleral buckling surgery were studied retrospectively. Including 3 eyes of simple macular hole retinal detachment; 6 eyes of giant rhegrnatogenous retinal detachment; 11 eyes of retinal detachment with pseudophakic; 7 eyes of retinal detachment with refractive stromal opacities; 14 eyes of retinal detachment with multiple-tear in multi quadrant; 6 eyes of retinal detach- ment with invisible holes, 8 eyes of retinal detachment with PVR C3; 6 eyes of retinal detachment with choroidal detachment; 12 eyes of macular hole retinal detachment with multiple-tear. Results Surgery of 70 eyes was successful, and visual function was close to the expected effect, 3 eyes failed of which had retinal detachment with macular hole and with choroidal detachment. Conclusions Individualized operation design, precise hole location, reasonable intraocular tamponade is the key of surgery. They will significantly improve success rate of scleral buckling surgery for complex rhegmatogenous retinal detachment.