上方球形视网膜脱离的手术

The surgery for superior bullous retinal detachment

目的 探讨用放液、玻璃体腔内注气、冷凝、加压 (drain- air cryotherapy explants,DACE)手术方法对上方球形或隆起较高的视网膜脱离进行治疗的效果。 方法 先在巩膜切口排出视网膜下液 ,在确信引流通畅情况下玻璃体腔内注气或注液 ,直至视网膜基本平复 ,视网膜裂孔定位 ,巩膜外冷凝 ,硅海棉加压块缝合。 结果 4 2只上方视网膜脱离眼采用 DACE手术方法完成 4 0只眼。在手术中用玻璃体腔注液替代注气 2 3只眼 ,其中 5只眼因视网膜隆起程度改善不满意而需注气。 1只眼在手术后 2周发生新的视网膜裂孔 ,行巩膜加压 ,手术后视网膜复位。手术后随诊期 ,全部手术眼视网膜复位。 结论 DACE是治疗上方球形或隆起较高的视网膜脱离眼实用、有效的手术方法。

Objective To investigate the technique of drain air, cryotherapy, and explant (DACE) of operation for superior bullous retinal detachment (SBRD). Methods In the DACE procedure, drainage and air or balanced salt soultion (BSS) injection were carried out first, with the intention of flattening the retina before localization of retinal hole, cryotherapy out of choroid and scleral buckling. Results In 42 SBRD eyes, 40 underwent the operation with DACE technique. In 23 eyes injected with BSS instead of air, 5 should be injected air due to no avail for flattening deeply retinal detachment, and 1 needed scleral buckling due to new retinal tear after DACE procedure two weeks. During the follow up, all retinae attached. Conclusions The DACE technique is very useful and effective in upper ballooned retinal detachment due to single hole or breaks localized in small area between the 10 and 2 o′clock meridiant. BSS instead of air injection can eliminate the difficulty of observation of retinal breaks from the presence of air in some cases.