原发性视网膜脱离患者玻璃体切割术前后球后血流动力学的研究

Retrobulbar Ocular Blood Flow Changes after Vitreoretinal Surgery in Patients with Primary Retinal Detachment

目的探讨原发性视网膜脱离(RD)患者玻璃体切割术前后球后血流动力学的变化,以及硅油填充、视网膜激光光凝对血流的影响。方法本研究为前瞻性对照研究。17例RD患者(17眼)均行玻璃体切割术治疗,对侧眼为对照眼,分别于玻璃体切割术前、取油术后采用彩色多普勒超声仪检测眼动脉(OA)、视网膜中央动脉(CRA)以及睫状后动脉(PCA)的收缩期血流峰值速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)。同时观察视网膜复位及视功能恢复情况。结果玻璃体切割术前RD眼的OA、CRA的PSV较对照眼显著降低,差异有统计学意义(P<0.05)。RD眼在硅油取出术后1周OA的PSV较术前显著增加,RI明显降低,差异有统计学意义(P<0.05)。硅油取出术后RD眼OA的RI与激光点数、硅油填充时间呈负相关,差异有统计学意义(P<0.05)。结论玻璃体切割术、术中光凝及硅油填充有助于视网膜复位,能够改善眼球血液供应。

Objective We analyzed retrobulbar ocular blood flow changes after vitreoretinal surgery in patients with primary retinal detachment(PRD).We then examined the influence of silicone filling time and laser photocoagulation of the retina on retrobulbar ocular blood flow.Methods A prospective consecutive study was conducted with 17 patients with primary retinal detachment(17 eyes)who were scheduled for vitrectomy surgery at the ophthalmology department of the Forth Affiliated Hospital,China Medical University.The contralateral eyes were the control group throughout the study.All the eyes were examined using color Doppler flow imaging(CDFI)on the day before vitrectomy surgery and on the seventh day after silicone oil removal.Peak systolic velocity(PSV),end diastolic velocity(EVD),and resistive indexes(RI)were assessed in the ophthalmic artery(OA),central artery(CRA),and posterior ciliary arteries(PCA).At the same time,we observed the condition of the retinal reattachment and recovery of visual function.Results The PSV of the OA and CRA was decreased as compared with those in the other arteries(P<0.05).PSV was significantly increased and RI was significantly decreased in the OA after silicone oil removal(P<0.05).We found a negative correlation between the change in RI in the OA and the number of laser points(P<0.05).Moreover,the decrease in RI in the OA and the time of silicone oil filling were positively correlated(P<0.05).Conclusion PPV,PRP,and silicone oil implantation are useful for retinal reattachment,which contribute to the improvement of retinal blood supply,in this study.