合并脉络膜脱离的视网膜脱离的临床观察

Clinical study of retinal detachment associated with choroidal detachment

目的:探讨合并脉络膜脱离的视网膜脱离手术治疗方法和手术时机的选择并观察疗效。方法:总结、分析2010-01/2012-01因视网膜脱离合并脉络膜脱离在我院住院的患者45例45眼,其中原发性裂孔源性视网膜脱离合并脉络膜脱离38例,复发性视网膜脱离合并脉络膜脱离7例。手术方法包括巩膜环扎、经巩膜穿刺口脉络膜上腔引流、玻璃体视网膜手术、眼内光凝、C3F8填充术或硅油填充术。结果:患眼45眼均行巩膜环扎术,均于手术中成功引流脉络膜上腔液体,6眼行C3F8填充,39眼行硅油填充术,45眼视网膜脉络膜全部复位,视网膜裂孔封闭。其中23眼术后视力≥0.1。结论:合并脉络膜脱离的视网膜脱离,采用巩膜环扎和玻璃体视网膜手术联合经巩膜穿刺口脉络膜上腔积液引流的联合手术方式有效。

AIM. To analyze the clinical characteristics of retinal detachment associated with choroidal detachment and to evaluate the surgical techniques, the efficacy and operation time for treatment. METHODS： We reviewed and analyzed the operative effects of vitreoretinal surgeries in 45 patients （45 eyes） with retinal and choroidal detachment in our hospital from January, 2010 to January, 2012. In these 45 patients, there were 38 patients of rhegmatogenous retinal detachment associated with choroidal detachment, 7 patients of retinal redetachment associated with choroidal detachment. The surgical techniques include scleral encircling operation, epichoroidal space drainage by sclerocentesis intraocular photocoagulation, gas- fluid exchange, perfluoropropane （ C3F8 ） or silicone oil intraocular tamponade and vitreoretinal surgery. RESULTS： The drainage of the suprachoroidal space liquid and blood was successful in 45 eyes. Silicone oil tamponade was performed for 39 eyes and C3F8 tamponade for 6 eyes. Retinas and choroids were all reattached and retinal holes were closed. Visual acuitieswere improved, ≥0.1 in 23 eyes. CONCLUSION： The vitreoretinal surgery and external drainage by scierocentesis and scieral encircling operation is an effective operating method for rhegmatogenous retinal detachment associated with choroidal detachment.