折叠顶压球囊治疗裂孔位置距角膜缘后≥15mm的孔源性视网膜脱离初步临床观察

Preliminary clinical observation on the treatment of rhegmatogenous retinal detachment with foldable capsule buckle at a distance of≥15 mm from the edge of the corneal membrane

目的:初步评价折叠顶压球囊(foldable capsule buckle,FCB)治疗孔源性视网膜脱离(rhegmatogenous retinal detachment,RRD)的有效性、安全性以及手术可操作性。方法:裂孔位置距角膜缘后≥15 mm的采用前瞻性临床病例研究。选择2020年3月至2021年9月在济南明水眼科医院院行FCB植入术治疗裂孔位置距角膜缘后≥15 mm的10例RRD患者(10眼)。应用眼部B型超声、眼底照相评价手术效果。根据术后有无FCB是否暴露、复视情况、排斥反应、眼球运动障碍等术后并发症的发生情况评价手术的疗效和安全性。结果:随访6个月~2年。10例RRD患者在术后通过眼部B超、眼底照相及光学相干断层扫描(optical coherence tomography,OCT)评估视网膜均复位。1例合并黄斑区视网膜脱离的患者视力提高。9例患者术后出现复视,术后1~3个月复视消失,1例在术后4个月仍存在复视,行FCB取出,术后视网膜未出现再脱离,复视症状消失。结论:初步研究可确定FCB植入治疗裂孔位置比较靠后(距角膜缘后≥15 mm)且传统巩膜扣带术操作难度大的孔源性视网膜脱离安全、有效,对眼球损伤小,易于操作。

Objective:To preliminarily evaluate the effectiveness,safety and surgical operability of foldable capsule buckle(FCB)in the treatment of rhegmatogenous retinal detachment(RRD).Methods:It is a prospective clinical case study.Ten patients(10 eyes),with a distance of≥15 mm from the posterior margin of the angular membrane at the location of the fissure,who underwent FCB implantation surgery for RRD at Jinan Mingshui Eye Hospital from March 2020 to September 2021 were enrolled.The surgical outcome was evaluated by B-ultrasound,fundus photography and optical coherence tomography(OCT).The surgical efficacy and safety were evaluated by the postoperative complications,such as FCB exposure,diplopia,rejection,and eye movement limitation.Results:The mean follow-up time was 1 year(6 months to 2 years).Retinal reattachment was evaluated by B-ultrasound,fundus photography and OCT after operation in 10 patients.One patient with macular retinal detachment had improved visual acuity.9 patients developed diplopia after operation,but diplopia disappears in 1-3 months after operation.One patient still had diplopia 4 months after operation,and FCB was removed 4 months after operation.No retinal detachment occurred after operation,and the symptoms of diplopia disappeared.Conclusion:It is confirmed by this preliminary research that the implantation of the foldable capsule buckle is safe,effective to treat rhegmatogenous retinal detachment with a relatively posterior position(≥15 mm from the back of the corneal limbus)with little damage to the ocular and easy to operate,compared with the difficulty and complexity in traditional scleral buckling surgery.