CAJ | 학술논문

背景:多裂孔性视网膜脱离是一种复杂的高致盲性眼病,传统的的环扎加压手术和新近开展的玻璃体切除术在视网膜脱离治疗中的作用是不同的,而在患者术后视功能的恢复上尤其值得关注.目的:比较分析多发裂孔性视网膜脱离患者行玻璃体切除术与环扎加压术的术后视功能恢复效果.设计:前后对照研究.单位:哈尔滨医科大学附属第二医院及附属第一医院眼科.对象:1999-10/2003-09在哈尔滨医科大学附属第二医院住院手术治疗的多裂孔性视网膜脱离患者,共173例173眼.方法:回顾性分析.比较同一时期多裂孔性视网膜脱离患者玻璃体切除术组(79眼)与环扎加压术组(94眼)的一次手术成功率、最终手术总成功率、术后视功能恢复情况及并发症的发生率.主要观察指标:①两组患者手术成功率及视功能恢复情况.②两组患者并发症的发生率.结果:玻璃体切除术组一次手术成功率92%,显著高于环扎加压术组81%(P＜0.05),术后视力提高者玻璃体切除术组54眼占68%,环扎加压术组50眼占53%,差异有显著性意义(P＜0.05).最终手术成功率和并发症的发生率两组间差异无显著性意义(P＞0.05).结论:对多裂孔性视网膜脱离的治疗,在选择好适应证的前提下,玻璃体切除术在一次手术成功率和术后视功能的恢复方面都优于环扎加压术.
배경:다렬공성시망막탈리시일충복잡적고치맹성안병,전통적적배찰가압수술화신근개전적파리체절제술재시망막탈리치료중적작용시불동적,이재환자술후시공능적회복상우기치득관주.목적:비교분석다발렬공성시망막탈리환자행파리체절제술여배찰가압술적술후시공능회복효과.설계:전후대조연구.단위:합이빈의과대학부속제이의원급부속제일의원안과.대상:1999-10/2003-09재합이빈의과대학부속제이의원주원수술치료적다렬공성시망막탈리환자,공173례173안.방법:회고성분석.비교동일시기다렬공성시망막탈리환자파리체절제술조(79안)여배찰가압술조(94안)적일차수술성공솔、최종수술총성공솔、술후시공능회복정황급병발증적발생솔.주요관찰지표:①량조환자수술성공솔급시공능회복정황.②량조환자병발증적발생솔.결과:파리체절제술조일차수술성공솔92%,현저고우배찰가압술조81%(P＜0.05),술후시력제고자파리체절제술조54안점68%,배찰가압술조50안점53%,차이유현저성의의(P＜0.05).최종수술성공솔화병발증적발생솔량조간차이무현저성의의(P＞0.05).결론:대다렬공성시망막탈리적치료,재선택호괄응증적전제하,파리체절제술재일차수술성공솔화술후시공능적회복방면도우우배찰가압술.
BACKGROUND: Retinal detachment with multiple tears is a complicated disease with high risk of blindness. Conventional scleral buckling and the much more recent vitrectomy differ in their effects for correcting retinal detachment, and the subsequent visual function recovery following the two surgeries needs thorough examination.OBJECTIVE: To compare conventional scleral buckling and vitrectomy for postoperative visual function recovery in the treatment of retinal detachment with multiple tears.DESIGN:A self-controlled clinical observationSETTING: Department of Ophthalmology, First and second Affiliated Hospitals of Harbin Medical University.PARTICIPANTS: A total of 173 eyes from 173 patients with retinal detachment with multiple tears were surgically treated in the Department of Ophthalmology between October 1999 and September 2003.METHODS: A retrospective analysis was performed for comparison of the single operation success rate, final operation success rate, improvement of visual function and incidence of complications between conventional buckling surgery(94 eyes) and vitrectomy(79 eyes).MAIN OUTCOME MEASURES:The operation success rate, improvement of visual function, and the incidence of complications in the two groups receiving different surgeries.RESULTS: Tne single operation success rate was significantly higher in vitrectomy group than in the buckling group(92% vs 81%, P ＜ 0.05). Vitrectomy resulted in visual function improvement in 54 eyes(68% ), and buckling surgery in 50 eyes (53%, P ＜ 0.05). The final success rate and incidence of complications were similar between the two groups ( P ＞ 0.05). CONCLUSION: Vitrectomy is a better option than buckling in treating retinal detachment with multiple tears concerning one-time operation success rate and visual improvement, provided the indications are properly defined.