CAJ | 학술논문

目的探讨首次玻璃体手术中下方周边部180°视网膜光凝对下方裂孔性视网膜脱离硅油取出手术后再脱离的影响.方法对142例(142只眼)下方裂孔性视网膜脱离行玻璃体视网膜手术硅油填充,尔后行硅油取出的临床资料进行回顾性分析.激光光凝组81例为首次行玻璃体手术时即对其下半180°周边部视网膜(除裂孔外)实施堤坝样光凝;对照组61例未行预防性视网膜激光光凝.结果硅油眼内填充时间为7～24周,平均硅油填充时间(11.8±2.6)周.硅油填充期间,光凝组硅油填充状态下视网膜脱离6例,占7.4%,对照组视网膜脱离10例,占16.4%,两组硅油状态视网膜脱离发生率比较,差异有统计学意义(P<0.05 ).油下视网膜脱离16例中,激光组6例.4例为增生性玻璃体视网膜病变引起,1例为预防性激光光凝手术后激光斑因受附近增生膜牵拉形成的新裂孔,1例原因不明:对照组10例,7例为遗漏小裂孔或原裂孔重新开放,3例为增生性玻璃体视网膜病变引起.硅油取出手术后11例患者发生视网膜再脱离,其中激光组3例,占3.7%;对照组8例,占11.4%.两组硅油取出后视网膜再脱离发生率比较,差异有统计学意义(P<0.05 ).硅油取出手术后视网膜再脱离11例中,激光组3例,2例为激光光凝斑受附近增生膜牵拉形成的新裂孔,l例为激光孔;对照组8例,4例为增生性玻璃体视网膜病变,2例为原裂孔开放,2例为原裂孔相邻部新裂孔.结论下方裂孔性视网膜脱离在首次玻璃体手术中行预防性下半侧周边部180°视网膜激光光凝与裂孔愈合和硅汕取出手术后视网膜再脱离发生率下降有关联.
목적 탐토수차파리체수술중하방주변부180°시망막광응대하방렬공성시망막탈리규유취출수술후재탈리적영향.방법 대142례(142지안)하방렬공성시망막탈리행파리체시망막수술규유전충,이후행규유취출적림상자료진행회고성분석.격광광응조81례위수차행파리체수술시즉대기하반180°주변부시망막(제렬공외)실시제패양광응;대조조61례미행예방성시망막격광광응.결과 규유안내전충시간위7～24주,평균규유전충시간(11.8±2.6)주.규유전충기간,광응조규유전충상태하시망막탈리6례,점7.4%,대조조시망막탈리10례,점16.4%,량조규유상태시망막탈리발생솔비교,차이유통계학의의(P<0.05 ).유하시망막탈리16례중,격광조6례.4례위증생성파리체시망막병변인기,1례위예방성격광광응수술후격광반인수부근증생막견랍형성적신렬공,1례원인불명:대조조10례,7례위유루소렬공혹원렬공중신개방,3례위증생성파리체시망막병변인기.규유취출수술후11례환자발생시망막재탈리,기중격광조3례,점3.7%;대조조8례,점11.4%.량조규유취출후시망막재탈리발생솔비교,차이유통계학의의(P<0.05 ).규유취출수술후시망막재탈리11례중,격광조3례,2례위격광광응반수부근증생막견랍형성적신렬공,l례위격광공;대조조8례,4례위증생성파리체시망막병변,2례위원렬공개방,2례위원렬공상린부신렬공.결론 하방렬공성시망막탈리재수차파리체수술중행예방성하반측주변부180°시망막격광광응여렬공유합화규산취출수술후시망막재탈리발생솔하강유관련.
Objective To investigate the effect of prophylactic 180°peripheral laser retinopexy dur- ing primary vitrectomy surgery on inferior rhegmatogenous retinal redetachment after silicone oil removal. Methods The clinical data of 142 patients who undertaken previous vitreetomy combined with silicone oil tamponade and later silicone oil removal surgery were retrospectively analyzed.Eighty-one patients (photoco- agulation group) was take prophylactic 180-degree dykelike laser retinopexy during the previous vilreoretinal surgery before the secondary silicone oil removal while 61 patients (control group) weren't.The incidence,time.the cause of retinal redetaehment and the complications of laser retinopexy after silicone oil removal intwo groups were observed.Results The duration of silicone oil tamponade was 7-24 weeks,averaging 11.8-2.6 weeks.During the period above.16 cases of retinal redetachment occurred;among them,there were 6 cascs (7.4%) in the photoeoagulation group (4 proliferative vitreoretinopathy cases,1 new break case,l un- known case) and 10 cases (16.4%) in the control group (7 cases resulted from omission of small retinal breaks or reopening of original hole.3 proliferative vitreoretinopathy cases).The difference belween two groups Was statistically significant(P<0.05).Eleven cages of retinal redetachment were recorded after silicone oil removal,including 3 casos (3.7%) in photocoagulation group (2 cases resulted from new tractional hole by nearby proliferative membrane.1 photocoagulation spot hole case) and 8 cases (11.4%) in control group (4 proliferative vitreoretinopathy Cases,2 reopening of primary retinal break cases,and 2 newly formed breaks beside the primary retinal breaks).Conclusions Prophylactic 180-degree peripheral laser retinopexy during primary vitrectomy surgery on inferior rhegmatogenous retinal redetachment is associated with a decrease of the incidence of retinal redetachment after removal of silicone oil.