目的 观察巩膜扣带术治疗视网膜周边裂孔继发黄斑裂孔视网膜脱离的手术疗效.方法 患者18例(18只眼),常规检眼镜下检查确诊为视网膜脱离,均为周边裂孔的視网膜脱离继发黄斑裂孔.治疗在局麻下行常规視网膜脱离复位术,冷凝周边裂孔,14例采用环扎带,周边裂孔位置外加压,4例单纯外加压.12例球内注入0.5~0.7 ml SF6气体,6例球内注消毒空气0.8~1.0 ml,术后俯位.术后第3天至6天在90度全视网膜镜下氪黄激光C形封闭黄斑裂孔.结果 18例患者手术均一次成功,随访6个月至1年,视网膜复位良好,黄斑孔贴附,隐约可见激光斑反应,視力0.05~0.1者10例,0.1~0.3者5例,视力≥0.3者3例,无1例并发白内障、青光眼.结论 巩膜扣带术治疗继发黄斑裂孔的视网膜脱离手术方法简单,成功率高,术后视力能得到一定程度改善.%Objective To observe the effects of scleral buckling on retinal detachment by periphery hole secondary macular hole. Methods Eighteen patients ( 18 eyes ) diagnosed retinal detachment because of periphery hole secondary macular hole using ophthalmoscope were included. We performed the regular operation for retina reattachment with cryotherapy of the periphery hole under local anesthesia. Fourteen cases were treated with sclera buckle and silica gel press,and four eyes were performed silica gel press only. Twelve patients were administrated intravitreally with SF6 0.5 ～ 0.7ml and six with sterilized air 0.8 ～ 1.0 ml. Patients kept prone position after operation and examed using the macular grid photocoagulation three to six day later. Results The operative effect was successful in eighteen patients followed up six month to one year. Retina was reattached and macular hole was repaired. Reaction of laser photocoagulation was not apparent. Visual acuity of ten patients was 0.05 to 0.1, five was 0.1 ～ 0.3, and 3 was equal or more than 0.3. No cataract or glaucoma was occured. Conclusion Scleral buckling for the treatment of retinal detachment by periphery hole secondary macular hole is easy and high successful. Visual acuity can be improved to extent after operation.
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