微创巩膜外加压术治疗单纯孔源性视网膜脱离患者对视网膜复位及预后影响

Effect of minimally invasive surgery for the treatment of retinal detachment and prognosis in patients with simple retinal detachment

目的探讨采用微创巩膜外加压术治疗单纯孔源性视网膜脱离患者的对眼底视网膜复位、视力恢复、角膜生物力学及中央厚度的影响作用。方法选取2012年6月至2014年1月在洛阳市中心医院眼科收治的100例（108只眼）患者作为微创组，微创组采用改良式微创小切口巩膜外加压手术治疗；另选40例正常研究对象作为对照组。观察微创组患者术后眼底视网膜复位情况、视力改善、角膜生物力学及中央厚度变化情况。结果术后24h，眼底视网膜达到复位标准的有95只眼、术后72h，达到眼底视网膜复位标准的有9只眼；手术一次性复位成功104只眼，复位率96．30％。术后3个月，视力达到〉0．4标准的有25只眼（23．15％）、视力范围0．1-0．3的有72只眼（66．67％）均显著的高于术前（P〈0．05）；术后视力范围光感-0．09的有11只眼（10．19％）显著的低于术前的67只眼（62．04％）。术后共计有12只眼发生术后并发症（11．11％）。术后3个月微创组患的IOPg、CRF、CH、GAT、IOPee测定值均恢复至正常组水平（P〉0．05），术后3个月微创组患者的CCT值低于正常组患者（P〈0．05）。结论微创巩膜外加压术治疗单纯孔源性视网膜脱离患者具有视网膜复位率较高、视力提高显著，对角膜生物力学及中央厚度影响小。

Objective To investigate the effects of minimally invasive surgery for the treatment of retinal detachment, visual acuity, corneal biomechanics and central thickness in patients with sim- ple hole derived retinal detachment. Methods A total of 100 cases （108 eyes） of retinal detachment were selected from June 2012 to January 2014 that were treated as minimally invasive group, mini- mally invasive group with modified small incision of sclera outside pressure surgical treatment, and 40 cases of normal subjects were selected as control group. Visual acuity, corneal biomechanics and central thickness changes were examined. Results Retina reached reset standard 24h after surgery had 95 eyes, after 72h had 9 eyes. The one-time successful reset operation had 104 eyes, and the re- set rate was 96.30%. After 3 months, the visual acuity 〉 0.4 were 25 eyes （23.15%）, vision ranged 0.1 to 0.3 72 （66.67%）, there were significantly higher than preoperative （P 〈0.05）; postoperative vi- sion ranged light perception had 11 eyes （10.19%）, there was significantly lower than the 67 preoper- ative （62.04%） 0.09. There were 12 eyes had postoperative complications （11.11%）. IOPg, CRF, CH, GAT, and IOPcc in minimally invasive group after 3 months were restored to normal levels （P 〉 0.05）, while the CCT value were lower than the normal group （P 〈0.05）. Conclusions Minimally in- vasive surgical treatment of scleral buckling for retinal detachment patients have a higher rate of reat- tachment, visual acuity improve significantly, central corneal thickness and biomechanical has little ef- fect.