23G或25G玻璃体切割术联合过氟萘烷治疗巨大裂孔性视网膜脱离33例临床分析

23G or 25G vitrectomy combined with fluorinated naphthalene alkane in the treatment of retinal detachments associated with giant retinal tears: analysis of 33 cases

目的:探讨23G或25G玻璃体切割术联合应用过氟萘烷治疗巨大裂孔性视网膜脱离的临床疗效,并讨论其临床意义。方法:回顾性分析2014年1月~2016年6月西安市第四医院眼科收治的巨大裂孔性视网膜脱离患者33例(33眼)。患者均行23G或25G玻璃体切割术,术中联合应用过氟萘烷、视网膜激光和注硅油等治疗以观察术后视网膜复位和视力,以及并发症等情况。结果:首次术后33例患者视网膜解剖上完全复位,未见严重并发症。其中2例术后1月因增生性玻璃体视网膜病变致视网膜再脱离再次手术治疗复位,1例取硅油术后2月因新的视网膜裂孔再次脱离行手术治疗后复位。术后平均随访15个月,未再发现视网膜脱离,视力也得到较好的恢复。结论:23G或25G玻璃体切割术联合应用过氟萘烷治疗巨大裂孔性视网膜脱离是一种手术成功率高、疗效良好的方法,值得临床推广应用。

Objective To investigate the therapeutic effects of retinal detachments associated with giant retinal tears treated with 23G or 25G vitrectomy and fluorinated naphthalene alkane （C10F18） and to analyze the clinical significance. Methods A retrospective survey was performed for 33 patients （33 eyes） with retinal detachments associated with giant retinal tears who were admitted to Xi’an No.4 Hospital between January 2014 and June 2016. All the patients underwent 23G or 25G vitrectomy combined with C10F18, laser retinopexy and silicone oil injection. After treatment, retinal reattachments, vision and complications were observed. Results Retinal attachments were achieved in all of 33 cases after the first surgery without serious complications. Two patients received a reoperation for retinal detachment due to proliferative vitreoretinopathy one month after the first surgery; one case had a reoperation for retinal detachment due to new retinal tears 2 months after silicone oil removal. After operation, the patients were followed up for an average of 15 months. The follow-up showed no retinal detachment and a better vision improvement. Conclusion 23G or 25G vitrectomy combined with C10F18 for patients with retinal detachments associated with giant retinal tears is worthy of clinical application for its high success rate of operation and good curative effect.