充气性视网膜固定术治疗孔源性视网膜脱离

Clinical observation on pneumatic retinopexy for the treatment of primary rhegmatogenous retinal detachment

目的探讨充气性视网膜固定术联合视网膜激光光凝治疗单纯孔源性视网膜脱离的效果及适应证。方法回顾性分析2006年11月至2013年6月我院眼科行充气性视网膜固定术29例（29眼）。根据视网膜裂孔大小及位置，玻璃体内注射C3F8气体0．3-0．6ml，视网膜裂子L闭合后行裂孔周围视网膜激光光凝。术后随访3个月～1年，观察视网膜复位情况、视力及并发症。结果23例经一次眼内充气后视网膜复位，3例行2次眼内注气后复位，2例改行巩膜扣带术，1例改行玻璃体切除术联合充气固定术，最终全组29例视网膜均复位，复位率为100％，无明显并发症。结论充气性视网膜固定术联合视网膜激光光凝术对无明显增生改变的上半部视网膜小裂孔的单纯孔源性视网膜脱离，手术成功率高，技术要求低，并发症少。

Objective To investigate the effects and indications of pneumatic retinopexy with laser photocoagulation for simple rhegmatogenous retinal detachment. Methods Twenty-nine eyes of 29 cases with simple rhegmatogenous retinal detachment who received pneumatic retinopexy combined with laser photocoagulation during the period of November 2006 to June 2013 were retrospectively reviewed. Depended on the location and the size of the retinal hole, 0.3-0.6 ml of C3F8 gas was injected into vitreous and then retinal laser photocoagulation was performed after the retinal hole closed. Postoperative follow up was for 3 months to 1 year. Retinal reattachmenl rate, visual acuity and adverse events were recorded. Results Twenty-three cases had successful retinal reattaehment with one surgery. Three cases were successful retinal reattachment after the injection of the gas twice. Two cases underwent scleral buckling to achieve final reattaehment and one case needed vitrectomy combined with gas tamponade. Final reattachment was obtained in all 29 cases. There was no obvious complication. Conclusion Pneumatic retinopexy combined with laser photocoagulation is an effective surgery for simple rhegmatogenous retinal detachment with small tear located in the above half of the retina and with no obvious proliferation. It is a simple surgery with high successful rate and fewer complications.