CAJ | 학술논문

目的探讨玻璃体切除术后裂孔性视网膜脱离外路显微手术的适应证及临床效果.方法回顾性系列病例研究.收集2010年9月至2013年7月间在宜昌市中心医院眼科行外路显微手术治疗的23例(23只眼)玻璃体切除术后,发生裂孔性视网膜脱离患者的临床资料.分析视网膜脱离的原因、视网膜复位的效果、视力改善情况以及手术并发症等.结果所有病例手术后随访3至12个月,平均(4.57±1.70)个月;一次手术视网膜解剖复位20例,手术成功率86.96％ (20/23);其它3例需再次行内路玻璃体切除联合硅油填充术;视力提高13只眼(56.52％),不变7只眼(30.43％),下降3只眼(13.05％).术后发生黄斑前膜1例(1只眼),并发性白内障2例(2只眼),未见其他严重并发症发生.结论对于PVR≤C1、裂孔位于赤道附近或赤道前的玻璃体切除术后裂孔性视网膜脱离同样可采用外路显微手术使视网膜复位,且具有操作方便、效果良好、并发症少等优点,可减少再次玻璃体切除术的机会.
목적 탐토파리체절제술후렬공성시망막탈리외로현미수술적괄응증급림상효과.방법 회고성계렬병례연구.수집2010년9월지2013년7월간재의창시중심의원안과행외로현미수술치료적23례(23지안)파리체절제술후,발생렬공성시망막탈리환자적림상자료.분석시망막탈리적원인、시망막복위적효과、시력개선정황이급수술병발증등.결과 소유병례수술후수방3지12개월,평균(4.57±1.70)개월;일차수술시망막해부복위20례,수술성공솔86.96％ (20/23);기타3례수재차행내로파리체절제연합규유전충술;시력제고13지안(56.52％),불변7지안(30.43％),하강3지안(13.05％).술후발생황반전막1례(1지안),병발성백내장2례(2지안),미견기타엄중병발증발생.결론 대우PVR≤C1、렬공위우적도부근혹적도전적파리체절제술후렬공성시망막탈리동양가채용외로현미수술사시망막복위,차구유조작방편、효과량호、병발증소등우점,가감소재차파리체절제술적궤회.
Objective To evaluate the effects of external-route microsurgery for the treatment of rhegmatogenous retinal detachment in selected eyes which had undergone vitrectomy.Methods A retrospective observational case series of 23 cases(23 eyes)had undergone vitrectomy as the first surgery for the treatment of various vitroretinal diseases.After the failure of the first surgery,external-route microsurgery was performed for the treatment of rhegmatogenous retinal detachment between September 2010 and July 2013.Under surgical microscope,the encircling and its suture were preplaced,then drainage of subretinal fluid or aqueous fluid,retinal cryotherapy,buckling,examination of locating the roles,encircling and intraocular injection of expanding gases or gas were performed.The retinal reattachment rate,visual outcome and postoperative complications were investigated.Results After 3 to 12(4.57±l.70)months follow-up period,the retinal reattachment rate was 86.96％(20/ 23 cases).Further vitrectomy surgeries were needed for other 3 eyes.Macular epiretinal membrane happened postoperatively in one eye,complicated cataracts were found in two eyes.There were no other serious complications.Conclusions The external-route microsurgery is also suitable for rhegmatogenous retinal detachment in vitrectomized eyes which are PVR≤CI and the roles locate in the equator region or front even.This way is simple,convenient and effective.The rate of secondary vitrectomy also can be reduced.