大裂孔和巨大裂孔的视网膜脱离患者行巩膜扣带术的临床观察研究

Clinical observation of scleral buckling in patients with retinal detachment with large or giant retinal hole

目的分析孔源性视网膜脱离(rhegmatogenous retinal detachment,RRD)中的视网膜大裂孔和巨大裂孔患者行巩膜扣带术的可行性、手术要点和视功能恢复情况。方法回顾性选择成都爱迪眼科医院2019年1月1日—2020年12月31日住院的RRD行巩膜扣带术的视网膜大裂孔和巨大裂孔的患者。观察患者的一般资料、并发症及术后恢复情况。结果共纳入RRD行巩膜扣带术住院患者344例(351只眼),其中大裂孔和巨大裂孔视网膜脱离患者43例(43只眼)。在43例患者中,男30例(30只眼),女13例(13只眼)。42例均一次性手术成功,均视网膜复位;1例手术失败,1周后行玻璃体切割术加硅油填充术,术后视网膜复位。术后患者均未出现严重并发症,多数患者术后视力均有不同程度提高。结论巩膜扣带术仍然是一种治疗RRD的有效手段。只要医师术前仔细检查,掌握手术要点,该术式仍然适合较多患者。该术式同时也保住了更多患者的玻璃体,维持了眼球的正常结构和眼内环境。

Objective To analyze the surgical feasibility,operative key points and visual function recovery of scleral buckling in patients with rhegmatogenous retinal detachment(RRD)with large or giant retinal hole.Methods RRD patients with large or giant retinal hole who underwent scleral buckling in Chengdu Aidi Eye Hospital between January 1,2019 and December 31,2020 were retrospectively selected.The general data,complications and postoperative recovery of the patients were observed.Results A total of 344 inpatients(351 eyes)underwent scleral buckling with RRD,including 43 patients(43 eyes)with retinal detachment of large or giant hole.Among the 43 patients,there were 30 males(30 eyes)and 13 females(13 eyes);42 cases were successfully operated and got retinal reattachment,and 1 failed.One week later,the patient underwent vitrectomy combined with silicone oil tamponade,and got retinal reattachment.No serious complications occurred in the patients after operation.The visual acuity of most patients improved after surgery.Conclusions Scleral buckling is still an effective method to treat RRD.It is still suitable for more patients as long as they are carefully checked before operation and the operators master the key points of operation.At the same time,more patients’vitreous bodies can be preserved,and the normal structure and intraocular environment of the eyeball can be maintained.