高度近视黄斑裂孔性视网膜脱离的再次手术

Second surgery for retinal detachment due to macular hole in the patients with high myopia

目的 评价高度近视黄斑裂孔性视网膜脱离再次手术的治疗效果。方法 对需再次手术的黄斑裂孔性视网膜脱离 17例 17眼 ,其中 11例是第 1次经玻璃体切割联合膨胀气体填充后黄斑裂孔未闭合 ,6例是黄斑裂孔闭合后晚期复发的患者行玻璃体切割 ,彻底黄斑前膜剥离 ,2例行视网膜内界膜剥离 ,全部病例联合硅油内填充 ,11例术后补充氩激光光凝。结果 17例 17眼黄斑裂孔闭合 ,视网膜全部复位 ,最终视力较术前提高。随访 3～ 2 4个月 ,视网膜复位良好 ,无 1眼复发。结论 黄斑裂孔性视网膜脱离再次手术中彻底剥离黄斑前膜 ,剥离视网膜内界膜 。

Objective To evaluate the efficacy of second surgery for retinal detachment due to macular hole in highly myopic eyes.Methods Seventeen eyes in 17 patients with retinal detachment due to macular hole in highly myopic eyes in which 11 eyes had underwent vitrectomy combined with C 2F 6 tamponde without macular hole closure, 6 eyes had underwent successful surgery before with macular hole reopening underwent closed vitrectomy , complete epiretinal membrane peeling, internal limiting membrane removal in 2 eyes, silicone oil tamponade, laser photocoagulation in 11 eyes. Results Seventeen eyes obtained successful retinal reattachment and macular hole closure. The final visual acuity increase at different point, after 3~24 months of follow up, the retinal reattachment remain in all cases.Conclusion Using the methods including closed vitrectomy, complete epiretinal membrane peeling, internal limiting membrane removal if necessary, silicone oil tamponade, laser photo coagulation may obtain good results in second surgery for retinal detachment due to macular hole in highly myopic eyes.