巩膜外加压直视下经周边裂孔视网膜下液引流术

Sub-retina fluid drainage under microscope with external scleral pressure as a modified procedure for periphery retinal holes

目的探讨巩膜外加压直接视下经周边裂孔视网膜下液引流术的临床疗效。方法我院2009年1月至2011年12月近3年期间,因周边视网膜裂孔而入住我院,并行玻璃体切除术的共43例(43只眼),对于周边裂孔引起的视网膜脱离,内路手术在解除了视网膜牵引,并完成人为视网膜脉络膜炎症后进行巩膜外加压直视下经周边裂孔引流视网膜下液。结果本组患者经行气-液(重水)交换后,37只眼(86.0%)眼视网膜下液引流较彻底,视网膜平伏,6只眼视网膜下液残存较多,摆放眼于正常位后,后极部视网膜脱离仍然明显。结论巩膜外加压,配合头位的直视下经周边裂孔视网膜下液引流术,避免了由视网膜造孔带来的手术风险。

Objective To investigate the therapeutic effects of draining sub-retina fluid under microscope with ex-ternal scleral pressure as a modified procedure for periphery retinal holes.Methods Author reviewed records of 43 pa-tients （43 eyes） with periphery retinal holes who received vitrectomy surgery combined with gas-fluid （ heavy water） ex-change in our hospital between January 2009 and December 2011.Relief of retinal traction and induction of inflammatory process in nearby tissues were done before the vitrectomy.Results There were 27 males and 16 females.Average age was 57.3 years with the range from 18 to 79 years.Average follow-up was 14.7 months with the range from 3 months to 2 years. In 37 eyes （86%） , sub-retinal fluid was properly drained and retina returned flat.In 6 eyes there was residual sub-retinal fluid and residual detachment at the posterior retina.Conclusion Sub-retina fluid drainage under microscope with external scleral pressure is an effective and safer treatment for peripheral retinal holes.