玻璃体切割联合剥膜硅油充填术治疗高度近视眼黄斑裂孔视网膜脱离的临床观察

The surgery method of Highly myopic macular hole retinal detachment

目的探讨不同手术方式治疗黄斑裂孔视网膜脱离(MHRD)的临床效果及安全性分析。方法选取本院2010年1月-2012年5月收治的60例(共108只)高度近视眼黄斑裂孔视网膜脱离患眼为研究对象,随机将患者分为观察组30例(共53只患眼)以及对照组30例(共55只患眼),观察组患者采用玻璃体切割联合剥膜硅油充填术,对照组患者行单纯玻璃体腔注气术治疗(C3F8),对比分析两组患者治疗后视力改善情、并发症发生、复发率情况及光学相干断层扫描(OCT)检查结果。结果观察组患者术后1个月内共有45只患眼视力提高,视力不变有8例,无视力下降,患者术后半年视力恢复率为94.34%;对照组患者术后视力1个月提高者有34例,视力不变者有21例,无视力下降,患者术后半年视力恢复率为76.36%。治疗后观察组中心凹厚度显著优于对照组,差异有统计学意义(P<0.05)。结论对MHRD患者应用玻璃体切割联合剥膜硅油充填术治疗可显著改善患者视力及中心凹厚度,降低患者术后并发症发生率,有利于患者预后。

Objective To investigate the clinical efficacy and safety analysis of surgical treatment of macular hole retinal detachment （MHRD） .Methods The high myopia eyes with macular hole retinal detachment were divided into 100 cases of observation group（a total of 55 eye） and 30 case of control group of 30 patients（ a total of 53 eye）.The observation group were treated with vitrectomy with silicone oil tamponade stripping treatment, control group were treated with simply intravitreal gas injection therapy, two groups were analyzed visual improvement after treatment, postoperative complications, postoperative recurrence rate as well as the occurrence of OCT findings. Results The patients within 1 month after a total of 45 visual acuity improved, unchanged vision in 8 patients, patients with no evidence of decreased visual acuity, visual acuity in patients after six months was 94.34%. Control group of patients a month postoperative visual acuity visual acuity improved in 34 cases, visual acuity remained unchanged in 21 cases, no vision loss, postoperative visual acuity was 76.36% six months. After treatment foveal thickness no difference （P〉0.05）, after treatment, the observation group foveal thickness was significantly better than the control group, the difference was statistically significant （P〈0.05）.Conclusion MHRD patients vitrectomy with silicone oil tamponade stripping treatment can significantly improve visual acuity and foveal thickness, reduce the incidence of postoperative complications, prognosis is good for patients.