CAJ | 학술논문

目的探讨先天性青光眼术后视网膜脱离的病因、临床特点及手术效果.方法对8例(8眼)先天性青光眼术后视网膜脱离行平坦部闭合式玻璃体切除联合视网膜切开、剥膜、硅油充填等治疗.术后观察视力、眼压、视网膜复位情况及并发症.结果随访6～24个月,视力提高4眼(50％),不变3眼(37.5％),下降1眼(12.5％)；眼压正常(10～21mmHg)者5眼(62.5％),使用前房穿刺联合降压药物后,眼压正常者2眼(25.0％),经药物及睫状体光凝术后,眼压正常者1眼(12.5％)；7眼首次手术后视网膜复位(87.5％),1眼二次手术后视网膜复位(12.5％)；8眼手术均无严重并发症发生.结论先天性青光眼术后视网膜脱离的病情复杂,玻璃体切除联合视网膜切开有助于视网膜复位,提高视功能,控制眼压的稳定.
목적 탐토선천성청광안술후시망막탈리적병인、림상특점급수술효과.방법 대8례(8안)선천성청광안술후시망막탈리행평탄부폐합식파리체절제연합시망막절개、박막、규유충전등치료.술후관찰시력、안압、시망막복위정황급병발증.결과 수방6～24개월,시력제고4안(50％),불변3안(37.5％),하강1안(12.5％)；안압정상(10～21mmHg)자5안(62.5％),사용전방천자연합강압약물후,안압정상자2안(25.0％),경약물급첩상체광응술후,안압정상자1안(12.5％)；7안수차수술후시망막복위(87.5％),1안이차수술후시망막복위(12.5％)；8안수술균무엄중병발증발생.결론 선천성청광안술후시망막탈리적병정복잡,파리체절제연합시망막절개유조우시망막복위,제고시공능,공제안압적은정.
Objective To investigate the pathology,clinical characteristics and therapeutic effects of retinal detachment after congenital glaucoma operation.Methods 8 cases(8 eyes)of retinal detachment after congenital glaucoma operation were treated by pars plana vitrectomy(PPV)combined with retinotomy,membrane peeling and silicone oil tamponade.The visual acuity,intraocular pressure,retinal reauachment and postoperative complications were observed.Results Follow-up period was 6～24 months after surgery.Visual acuity increased in 4 eyes(50％),maintained in 3 eyes(37.5％),and decreased in 1 eye(12.5％).The intra ocular pressure of 5 eyes were lower than 21 mmHg(1 nun Hg =0.133 kPa)(62.5％),2 eyes lower than 21 mmHg with drugs and paracentesis of anterior chamber(25.0％),1 eye lower than 21 mmHg with drugs and cyclophotocoagulation(12.5％); 7 eyes obtained retinal reattachment undergoing once surgical treatment(87.5％),1 eye obtained retinal reattachment after two surgeries(12.5％).Serious postoperative complication was not observed.Conclusion The pathology of retinal detachment after congenital glaucoma operation were complex.PPV combined with retinotomy were helpful for retinal reattachment,which were helpful for visual acuity improvement and normal intraoeular pressune.