后巩膜加固术治疗高度近视黄斑劈裂

Effect of posterior scleral reinforcement in the treatment of pathological myopic macular retinoschisis

目的探讨改良的后巩膜加固术对高度近视黄斑劈裂的治疗效果。方法对18只眼（13例）高度近视黄斑劈裂患者行改良的后巩膜加固术。术后观察患者的最佳矫正视力、屈光度、眼轴长度、黄斑中心凹厚度的变化及手术并发症。结果术后随访期最佳矫正视力较术前有提高，差异有统计学意义（P〈0．05）。近视屈光度和眼轴长均较术前减少，差异有统计学意义（P〈0．05）。光学相干断层扫描（OCT）示劈裂的视网膜内外层之间的腔隙均有不同程度的缩小（黄斑中心凹视网膜总厚度降低），其中有6只眼劈裂腔完全消失，黄斑部视网膜达到解剖复位，5只眼旁中心凹处仅可见细小裂隙，差异有统计学意义（P〈O．05）。1只眼发生黄斑出血。结论对于高度近视黄斑劈裂伴或不伴视网膜脱离的治疗，改进的后巩膜加固术具有较好的可行性和安全性。

Objective To investigate the effect of posterior scleral reinforcement in eyes with pathological myopic macular retinoschisis. Methods 18 eyes （13 cases）of pathological myopic macular retinoschisis who underwent surgery with the posterior scleral reinforcement were studied. Observe the patient＇s postoperative best corrected visual acuity, diopter, axial length, the central foveal thickness and surgical complications. Results Visual acuity improved postoperative follow-up corrected, there are significantlly statistically differences （P〈 0. 05）. Myopic degree of equivalent spherical mirrors and axial length were compared with preoperative reduced, there are significantlly statistically differences（P〈0.05）. Optical coherence tomography（OCT）of splitting the lacuna between layers of retina have varying degrees of narrowing（macular center concave total retinal thickness decrease）, there are six eye split cavities completely disappear,macular retinal anatomical repositioning, 5 eyes sunken place only visible tiny fractures near center, there are significantlly statistically differences（P〈0.05）. 1 eye macular hemorrhage. Conclusion For high myopia macular splitting with or without the treatment of retinal detachment,modified posterior scleral reinforcement has good feasibility and safety.