玻璃体手术治疗伴脉络膜脱离的孔源性视网膜脱离临床研究

Clinical study of vitreous surgery for rhegmatogenous retinal detachment associated with choroidal detachment

目的评价玻璃体手术联合眼内填充硅油治疗合并脉络膜脱离的孔源性视网膜脱离的效果。方法临床确诊的孔源性视网膜脱离合并脉络膜脱离的患者共21例(21眼)纳入研究。在非接触式广角镜下,患者均行闭合式玻璃体手术及硅油填充,部分患者联合晶状体手术。观察手术前后视力变化、眼压变化以及术后视网膜复位率等情况。结果一次手术视网膜复位15眼(71.5%),多次手术最终视网膜复位19眼(90.5%)。最终视力>0.1者7眼(33.3%),手术后视力提高者共17眼(80.9%)。术前眼压平均6.1 mmHg,术后眼压平均14.8 mmHg,术后眼压明显改善,两者相比差异有统计学意义。结论合并脉络膜脱离的孔源性视网膜脱离玻璃体手术处理得当可获得较好的效果。

Objective To evaluate the efficacy of vitreous surgery combined with silicon oil tamponade for patients with rhegmatogenous retinal detachment associated with choroidal detachment. Methods A total of 21 patients with rheg- matogenous retinal detachment associated with choroidal detachment were enrolled in this study. All the patients received vitrectomy and silicone oil tamponade with using non-contact wide-angle lens and some patients received combined lens surgery. The pre- and post-operative visual acuity, intraocular pressure （IOP） and retinal reattachment rate were ana- lyzed. Results The rate of retinal reattachment after single-surgery was 71.5% （ 15/21 ） and final reattachment rate was 90.5% （ 19/21 ）. The best corrected visual acuity （BCVA） was 〉0.1 in 7 eyes （33.3%） after surgery, and vis- ual acuity increased in 17 eyes （80.9%）. Average intraocular pressure（lOP） was 6.1 mmHg before surgery and 14.8 mmHg after surgery, with a significant difference between them （ P 〈 0.05 ）. Conclusion Vitreous surgery combined with silicon oil tamponade for patients with rhegmatogenous retinal detachment associated with choroidal detachment is efficient and safe.