摘要
目的观察非接触广角观察系统及23G眼内照明辅助下的巩膜外垫压治疗孔源性视网膜脱离(RRD)的安全性及有效性。方法6例RRD患者6只眼接受非接触广角观察系统及23G眼内照明辅助下的巩膜外垫压手术。其中,男性2例2只眼;女性4例4只眼。年龄23~66岁,平均年龄51岁。视网膜脱离发生距手术时间为2~13d,平均时间为5.8d。增生性玻璃体视网膜病变(PVR)分级均为B级。眼压9~15mmHg(1mmHg=0.133kPa),平均眼压12mmHg。自睫状体平坦部插入23G导光纤维探头,在非接触广角观察系统辅助下检查全周视网膜并冷冻视网膜裂孔和变性区。在手术显微镜下完成巩膜切开引流视网膜下液及缝合硅胶带。手术结束时眼内注人无菌空气4只眼。手术后常规抗炎治疗,并随访观察不低于6个月。结果6只患眼手术后视网膜均完全复位,视力均提高。结膜愈合良好,眼压12~19mmHg,平均眼压15mmHg。均无手术中及手术后并发症。结论非接触广角观察系统及23G眼内照明辅助下的巩膜外垫压手术安全有效。与以往双目间接检眼镜辅助下的手术方式相比,手术成功率高,并发症少,手术时间短,患者手术中痛苦小。
Objective To create a new scleral buckling surgery using noncontact wide-angle viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment (RRD), and to evaluate its safety and effectiveness. Methods A scieral buckling surgery using noncontact wide-angle viewing system and 23-gauge intraocular illumination was performed in 6 eyes of 6 patients with RRD, including 2 males and 4 females. The mean age was 51 years old with a range from 23 to 66 years old. Proliferative vitreoretinopathy (PVR) were diagnosed of grade B in all 6 eyes. Duration of retinal detachments until surgery was 5.8 days with a range from 2 to 13 days. The mean preoperative intraocular pressure (IOP) was 12 mmHg with a range from 9 to 15 mmHg (1 mmHg:0. 133 kPa). A 23-gauge optic fiber was used to provide an intraocular illumination. Fully examination of the ocular fundus and cryoretinopexy of retinal breaks was performed under a noncontact wide-angle viewing system. Subretinat fluid drainage through the sclerotomy and buckling procedure were performed under the operating microscope. Intravitreal injection of sterile air bubble was performed in 4 eyes. Antibiotic eye drops was applied in all eyes postoperatively, and all the eyes were followed up for at least 6 months. Results Retinal reattachment was achieved in all eyes, and the conjunctiva healed well. The best corrected visual acuity (BCVA) increased in all eyes. The mean postoperative IOP was 15 mmHg with a range from 12 to 19 mmHg. No complications were found intra and postoperatively. Conclusions This new scleral buckling surgery using noncontact wide-angle viewing system and 23-gauge intraocular illumination for RRD is safe and effective. Advantages such as higher successful rate, less complication, shorter operating time, and less discomfort of patients were showed comparing with the previous scleral buckling surgery using indirect ophthalmoscope.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2014年第1期59-61,共3页
Chinese Journal of Ocular Fundus Diseases
关键词
视网膜脱离
外科学
巩膜扣带术
方法
外科手术
微创性
方法
Retinal detachment/surgery~ Scleral buckling/methods~ Surgical procedures,minimally invasive/methods