老年人视网膜脱离30例临床分析

A clinical study of 30 cases of elderly men's retinal detachment

目的 分析老年人视网膜脱离的特点、原因、发病率及治疗效果。方法 对 30例 6 0岁以上老年人视网膜脱离的病因、屈光、裂孔情况、玻璃体膜分级、手术方法、疗效及预后作综合分析。结果 发病率占同期视网膜脱离的 31.9% ,老年男性非近视眼占到周边裂孔源性视网膜脱离的 5 2 % ,玻璃体变性是重要原因。女性近视眼是黄斑裂孔源性视网膜脱离的主要原因 ,两斜肌附着部视网膜应力较大区域是老年人视网膜裂孔多发地带 ,就诊迟、脱离范围广是影响视力预后的主要因素 ,早期手术 ,预后良好 ,周边裂孔选择环扎加压术 ,黄斑孔以及大锯齿缘裂孔选择环扎加压结合玻璃体注气术 ,成功率 96 .4 %。结论 对有玻璃体液化、混浊、后脱离的高危老人 ,应注意限制体力活动 ,减少导致眼球旋转运动的动作 ,对老年人视力减退者 ,不论有无近视均应详细检查眼底 ,有视网膜脱离应尽早手术治疗 。

Objective The object of this article is to analysis the characteristic,cause,incidence,and the curative effect of elderly men's retinal detachment.Methods In order to find a solution,we synthetically analyse the cause,the refraction change retinal tears vitreous membrane grade,surgical procedure effects and prognosis of 30 cases which are collected from more than 60 years old people.Results The incidence of the disease is about the 31.9% of retinal detachment at the corresponding period.Elderly men with no myopia are about 52% of the men who suffer from marginal tears retinal detachment,in which the denature of vitreous body is an important cause.The women's myopia is the main reason of retinal detachment caused by the fovea tear.The two oblique stop with more retinal stress are the areas where elderly men's retinal tears occurred frequently.Late hospitalizing and wide retinal detachment are the main reasons of infecting eyesight prognosis.Inchoate operating can obtain good prognosis.The rate of success reaches 96.4% when using sclera circling and buckling for marginal tears,and using the sclera circling and buckling combinal with gas tamping for fovea tears and ora serrata's big tears.Conclusion The elderly men with the liquefied,cloud and post-deviate of vitreous body who are in high danger,whether they are myopia or not should decrease physical activities and eyeball's turn caused by action.They should examine their ocular fundus and pay attention to retinal detachment when their eyesight decrease,so that they can be cured by operation earlier.They should go to hospital regularly.