定量放液联合巩膜外垫压治疗泡状视网膜脱离的临床观察

摘要

目的：探讨定量放视网膜下液联合巩膜外垫压治疗泡状视网膜脱离的安全性及疗效。方法选择孔源性视网膜脱离表现为泡状视网膜脱离58例58只眼行巩膜外垫压术。根据术前观察的视网膜脱离范围估计放液量。视网膜下液由助手用冲洗钝针头在穿刺口附近抽吸定量。术后随访3个月观察视力、眼内反应和视网膜复位情况。结果术中平均放液量为(0．83±0．35)mL。术后视网膜完全复位57只眼,1只未复位者为人工晶体眼。手术后最佳矫正视力较术前提高,差异有统计学意义(P=0．01)。除1只眼出现视网膜下出血,其它病例无放液并发症。术后随访3个月,除未复位1眼外,未发现玻璃体增殖较术前进展眼。结论定量排放视网膜下液联合巩膜外垫压治疗泡状视网膜脱离安全有效。%Objective To study the effectiveness and security of modified quantitative drainage in scleral buckling proce-dure for vesicular retinal detachment. Methods 58 eyes(58 cases)with rhegmatogenous retinal detachment of vesicular retinal de-tachment were included in this study. According to the preoperative observation of retinal detachment range,we estimated the drain-age amount. The suction of the subretinal fluid was applied by assistant using washing blunt needle near the piercing mouth. In the postoperative follow-up of 3 mon,visual acuity,intraocular reaction and retinal reattachment were recoded. Results The intraoper-ative drainage amount was(0. 83 ± 0. 35)mL. The retina of 57 eyes reattached,except one with artificial lens. Best corrected Visual acuity improved after the operation ( P =0. 01 ) . No drainage complications happened except one subretinal hemorrhage. In the postoperative follow-up of 3 mon,besides one case whose retina was not reset,vitreous proliferation was not found. Conclusion Modified quantitative drainage in scleral buckling procedure for vesicular retinal detachment is a the effective and safe method.