巩膜外冷凝最小量气囊垫压术治疗视网膜脱离

Minimal amount of air bag pressure and external cryocoagniation of retina for the treatment of retinal detachment

目的观察巩膜外冷凝联合最小量气囊垫压术治疗孔源性视网膜脱离的效果。方法对34例（34眼）孔源性视网膜脱离行视网膜外冷凝联合最小量气囊垫压术的临床资料进行回顾性分析。术后7d放气抽出气囊，随访5—12个月，观察视网膜复位、矫正视力及并发症等情况。结果34眼中，视网膜复位31眼，占91．18％，视网膜复位不良3眼，其中不规则裂孔1眼，人工晶状体眼2眼。此3眼中2眼行巩膜扣带术，1眼行玻璃体切除联合长效惰性气体填充，术后视网膜复位，术中均发现遗漏裂孔而致第一次手术失败。视网膜复位31眼中，术后1个月视网膜脱离复发3眼，2眼为马蹄形裂孔位于上部象限，1眼为人工晶状体眼。此3眼中1眼行巩膜扣带术，2眼行玻璃体切除联合硅油填充术后，视网膜复位。末次随访时，32眼视网膜复位，矫正视力提高5-10行23眼，占67．65％，提高3～4行8眼，占23．53％，无明显变化3眼，占8．82％，所有患眼元严重并发症发生。结论巩膜外冷凝联合最小量气囊垫压术治疗孔源性视网膜脱离安全有效，且手术时间短，切口小，患者痛苦小，术后恢复快，预留其他手术的术野多。

Objective To observe the efficacy of minimal amount of air bag pressure and external cryocoagulation of retina for the treatment of retinal detachment. Methods The data of 34 eyes of 34 cases with rhegmatogenous detachment of retina were collected and analyzed retrospectively . They underwent minimal amount of air bag pressure combined with external cryocoagulation of retina. The retinal reattachment, corrected visual acuity and complications were observed after surgery. The follow-up period was 5-12 months. Results In 34 eyes, retinal reattachment was found in 31 eyes （ 91. 18% ） , poor retinal reattachment in 3 eyes, included irregular crack hole of I eye and pseudophakic of 2 eyes. Among 3 eyes, 2 eyes underwent scleral buckling operation and 1 eye underwent vitrectomy combined with C3 Fs tamponade. The omissive retinal tear caused the first surgrey faliure was found during the second surgery. Among 31 eyes of retinal reattachment, retinal detachment recurred in 3 eyes 1 month after surgery, 2 eyes were horse-shoe holes located in the upper quadrant, 1 eye was pseudophakic. Among them, 1 eye underwent scleral buckling operation, 2 eyes underwent vitrectomy combined with silicone oil tamponade after retinal reattachment. At the last follow-up, retinal reattachment were in 32 eyes, corrected visual acuity improved 5-10 lines in 23 eyes （ 67.65% ）, improved 3- 4 lines in 8 eyes （ 23. 53% ）, and 3 eyes without significant changes （ 8.82% ）. No serious complication occurred. Conclusion Minimal amount of air bag pressure and external cryocozgulation of retina for the treatment of rhegmatogenous retina detachment is safe and effective, with short time of operation, small incision and less pain to the patients, rapid recovery after operation and keeping more field for other operations.