视网膜脱离术后顽固性视网膜下积液的治疗

The therapy of delayed subretinal fluid after retinal detachment surgery

目的 分析视网膜脱离术后顽固性视网膜下液的形成原因 ,并对其治疗方法进行了探讨。方法 对2 85例视网膜脱离术后出现顽固性视网膜下液的 2 3例 (2 3只眼 )患者 ,在常规治疗 1月无效后 ,对玻璃体牵引不明显的 12例进行药物治疗 ,其中 5例不吸收者行针刺放液和巩膜外环扎 ,3例行激光堤坝式光凝 ,11例玻璃体牵引明显者行玻璃体切割术。结果 随访一年 ,牵引不明显的 12例视网膜下液在 8～ 39周内吸收 ,牵引明显的 11例中3例出现复发性网脱 ,经再次玻璃体切割术后恢复 ,余视网膜均复位良好。讨论 顽固性视网膜下液的发生与裂孔的位置、患者年龄、冷凝强弱、玻璃体牵引及巨大裂孔放液位置有关 ,为减少增生性玻璃体视网膜病变 ,尽可能恢复视功能 ,应针对不同病因及时进行相应的治疗。

Objectiev To analyse the reasons of delayed subretinal fluid after retinal detachment surgery and question the according theraputic measures.Methods There were 23 persons with delayed subretinal fluid among 285 ones after retinal detachment surgery.The effects weren't taken after 1 month regular theraphy,so that we treatment 12 eyes with no severe traction in medicine or encircling and performed vitrectomy to 11 eyes with severe traction.Results Following one year,the subretinal fluid of 12 eyes with no severe traction was absorbed from 8 to 39 weeks.3 eyes among 11 eyes with severe traction which suffered from re-retinal detachment recovered after re-vitrectomy and the others all recruited well.Conclusions We find there are connections between delayed subretinal fluid and location of the holes or tears,age of the patients,the degree of crycoagulation and the location of draining in giant tear.In order to decrease proliferative vitroretinal desease and increase visual function,the therapy should be carried out in time according to the reasons of delayed subretinal detachment.