远离角膜缘的球结膜切口在巩膜外加压术中的临床应用效果评估

Clinical efficacy evaluation of conjunctival incision away from the limbus in scleral buckling surgery

目的探讨远离角膜缘的球结膜切口在巩膜外加压术中应用的可行性及临床效果。方法对38例孔源性视网膜脱离适合行最小量单纯巩膜外加压术患者进行治疗,结膜切口位于视网膜裂孔所在象限,距角膜边缘10 mm,根据裂孔大小做平行或垂直角膜缘的切口,巩膜缝线硅海绵块加压,检查眼底确保正确的孔嵴关系,分别缝合Tenon囊和球结膜。观察术后眼底视网膜复位情况及术后并发症发生情况。结果视网膜完全复位36眼,好转1眼,复位失败1眼,复发4眼,复位率为90.00%;术后视力提高36眼,不变3眼,下降1眼,与术前比较差异显著(P<0.05)。结论巩膜外加压术中应用远离角膜缘的球结膜切口,创伤小,且术后视网膜复位率与传统结膜切口手术相同,值得临床推广。

Objective To investigate the feasibility and efficacy of limbal conjunctival away from the scleral incision surgery application. Method 38 cases with retinal detachment appropriate to the simply scleral buckling surgery, conjunctival incision election in quadrant retinal hole, 10 mm from the edge of the cornea position, the traction lines were present to parallel or perpendicular to the corneal limbus according to the size of the hole incision, silicone sponge scleral sutures pressure, fundus examination to ensure that the correct hole crest relationship. Tenon capsule and bulbar conjunctiva were sutured respectively, and the retinal reattachment and postoperative complications were observed. Result Conjunctival incision healed completely at the end of follow-up, retinal improvement was 1 eye, reset failed was 1 eye, recurrence was 4 eyes, reduction rate was 90.00%; 36 eyes vision improved after surgery, 3 eyes unchanged, 1 eye eyesight increased, those were significantly difference compared with the preoperative（P〈0.05）. Conclusion The retinal detachment surgery with limbal conjunctival away from the scleral incisionhas small trauma, and were in the same reset rate with conventional conjunctival incision surgery, it was worthy promoting.