国际眼科杂志
國際眼科雜誌
국제안과잡지
INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
2014年
4期
695-697
,共3页
赵春阳%李永雄%李冬莲%黄国舜
趙春暘%李永雄%李鼕蓮%黃國舜
조춘양%리영웅%리동련%황국순
孔源性视网膜脱离%外路显微手术
孔源性視網膜脫離%外路顯微手術
공원성시망막탈리%외로현미수술
rhegmatogenous retinal detachment%external-route microsurgery
目的：总结孔源性视网膜脱离外路显微手术关键技术的临床应用情况。<br> 方法：孔源性视网膜脱离152例，手术显微镜下完成穿刺排液、冷凝、裂孔定位、硅胶垫压等关键技术。<br> 结果：一次手术复位率89．5％，总复位率96．7％；术后1mo，矫正视力＞0．05者89．8％，＞0．3者35．2％；一次穿刺排液成功83．6％，硅胶垫压环扎后需再穿刺排液占13.1％；显微镜下裂孔冷凝定位准确率82．9％，术中调整后准确率90．0％；术中硅胶位置调整占6．6％，需再次手术调整占10．6％；95．4％硅胶垫压后缘位于角膜缘后20 mm以前，4．6％位于20 mm以后。<br> 结论：孔源性视网膜脱离外路显微手术可获得期望的临床效果，其关键技术应用简便、可靠，出现偏差时可适时调整；视网膜可观察范围达角膜缘后20mm，大眼轴高度近视者可达角膜缘后20～24 mm。
目的：總結孔源性視網膜脫離外路顯微手術關鍵技術的臨床應用情況。<br> 方法：孔源性視網膜脫離152例，手術顯微鏡下完成穿刺排液、冷凝、裂孔定位、硅膠墊壓等關鍵技術。<br> 結果：一次手術複位率89．5％，總複位率96．7％；術後1mo，矯正視力＞0．05者89．8％，＞0．3者35．2％；一次穿刺排液成功83．6％，硅膠墊壓環扎後需再穿刺排液佔13.1％；顯微鏡下裂孔冷凝定位準確率82．9％，術中調整後準確率90．0％；術中硅膠位置調整佔6．6％，需再次手術調整佔10．6％；95．4％硅膠墊壓後緣位于角膜緣後20 mm以前，4．6％位于20 mm以後。<br> 結論：孔源性視網膜脫離外路顯微手術可穫得期望的臨床效果，其關鍵技術應用簡便、可靠，齣現偏差時可適時調整；視網膜可觀察範圍達角膜緣後20mm，大眼軸高度近視者可達角膜緣後20～24 mm。
목적：총결공원성시망막탈리외로현미수술관건기술적림상응용정황。<br> 방법：공원성시망막탈리152례，수술현미경하완성천자배액、냉응、렬공정위、규효점압등관건기술。<br> 결과：일차수술복위솔89．5％，총복위솔96．7％；술후1mo，교정시력＞0．05자89．8％，＞0．3자35．2％；일차천자배액성공83．6％，규효점압배찰후수재천자배액점13.1％；현미경하렬공냉응정위준학솔82．9％，술중조정후준학솔90．0％；술중규효위치조정점6．6％，수재차수술조정점10．6％；95．4％규효점압후연위우각막연후20 mm이전，4．6％위우20 mm이후。<br> 결론：공원성시망막탈리외로현미수술가획득기망적림상효과，기관건기술응용간편、가고，출현편차시가괄시조정；시망막가관찰범위체각막연후20mm，대안축고도근시자가체각막연후20～24 mm。
AIM: To conclude the clinical situation of the key techniques used in the external-route microsurgery for rhegmatogenous retinal detachment. <br> METHODS:A total of 152 patients with rhegmatogenous retinal detachment who underwent drainage of sub -retinal fluids, cryotherapy, localization of the retinal break, silicone scleral buckling by surgical microscope. <br> RESULTS:Retinal reattachment were achieved in 89.5%of patients after the primary surgery and the final reattachment rate was 96.7%, and 89.8% of the eyes achieved the corrected visual acuity high above 0.05, 35.2%above 0.3 at 1mo postoperatively.In 83.6%of eyes had a succeed drainage of sub-retinal fluids by the first acupuncture, and 13.1%of eyes achieved it by the second try after silicone buckling and circling;in 82.9%of cases, the retinal tear localization directly under microscope was accurate, in 90.0% of eyes were achieved it after check and adjustment by the end of operation; in 6.6% of cases, the scleral buckling had to be adjusted to more correct position in the first operation, and 10.6% of eyes had to be adjusted in the next operation; in 95.4% of eyes, the posterior edge of silicone buckling were within 20mm behind corneal limbus, 4.6%of eyes were behind 20mm. <br> CONCLUSION: The external-route microsurgery can bring us expected clinical results for rhegmatogenous retinal detachment.Its key microsurgical techniques are applied in convenient, reliable, and can be adjusted timely when some deviations occurred.The observable retina under microscope range from ora serrata to 20mm behind corneal limbus, and even to 20-24mm in some high myopia eye with large axial length.
