最小量巩膜扣带术治疗累及黄斑的孔源性视网膜脱离疗效观察

Effect of minimal scleral buckling on rhegmatogenous retinal detachment involving macula

目的探讨最小量巩膜外扣带手术治疗累及黄斑的孔源性视网膜脱离(RRD)的疗效。方法回顾性分析2019年1月至2021年12月安徽医科大学第四附属医院眼科收治的36例(36只眼)累及黄斑的RRD患者的临床资料,均行最小量巩膜外扣带手术。术后随访3个月,观察术眼手术前后黄斑结构、最佳矫正视力(BCVA)及泪膜稳定性恢复情况。结果术前,术后1、2、3个月黄斑平均视网膜厚度、椭圆体带破坏累计长度、最小分辨角对数BCVA比较,差异均有统计学意义(P<0.05);外界膜破坏累计长度比较,差异均无统计学意义(P>0.05)。术前与术后1个月泪膜破裂时间、眼表疾病指数评分比较,差异均无统计学意义(P>0.05)。结论最小量巩膜外扣带手术治疗累及黄斑的RRD安全、有效,黄斑微结构恢复,视力提高,泪膜稳定性恢复快。

Objective To observe the effect of minimal external scleral buckling surgery on rhegmatogenous retinal detachment(RRD)involving macula.Methods The clinical data of 36 patients(36 eyes)with RRD involving macula from January 2019 to December 2021 in the Department of Ophthalmology,the Fourth Affiliated Hospital of Anhui Medical University were retrospectively analyzed.All patients underwent minimal scleral buckling surgery.After three months follow-up,the macular structure,the best corrected visual acuity(BCVA)and the recovery of tear film stability were observed before and after operation.Results There were significant differences in average macular retinal thickness,cumulative length of ellipsoidal zone damage and minimum resolution angle logarithm BCVA before operation,1,2 and 3 months after operation(P<0.05).Compared with the cumulative length of external damage,the difference was not statistically significant(P>0.05).There was no significant difference in tear film rupture time and ocular surface disease index score between preoperative and postoperative one month(P>0.05).Conclusion Minimal scleral buckling surgery is safe and effective in the treatment of RRD involving macula,with the recovery of macula microstructure,improvement of vision and rapid recovery of tear film stability.