CAJ | 학술논문

目的观察微创玻璃体切割手术治疗脉络膜脱离型视网膜脱离的临床疗效及安全性.方法临床检查确诊的脉络膜脱离型视网膜脱离患者35例36只眼纳入研究.其中,男性22例,女性13例.平均年龄(51.32±17.34)岁.视力光感6只眼；手动/眼前者12只眼；数指者9只眼；0.01～0.1者8只眼；0.2～0.3者1只眼.平均最小分辨角对数(LogMAR)视力为2.13±0.50.平均眼压为(9.17±6.28) mm Hg(1 mm Hg=0.133 kPa).患者均行23G联合25G经结膜无缝合玻璃体手术.手术中硅油填充35只眼,C3 F8填充1只眼.手术后平均随访时间(6.23±3.07)个月.对比观察手术前后视力、眼压变化情况,以及手术后视网膜复位率、视网膜脱离再发生率及并发症等情况.结果手术后1d,所有患眼视网膜均复位,占100.0％；手术后1个月,视网膜复位33只眼,占91.7％；视网膜局限性脱离3只眼,占8.3％,再次行巩膜扣带手术,视网膜复位.手术后3个月,视网膜复位30只眼,占83.3％.手术后1d,1、3个月平均LogMAR视力分别为1.77±0.66、1.53±0.72、1.31±0.77,与手术前平均LogMAR视力比较,差异有统计学意义(F=62.61,P＜0.05).手术后1d,1、3个月眼压分别为(12.47±7.28)、(15.51±6.86)、(15.82±7.60) mm Hg(1 mmHg=0.133 kPa).手术后各时间点平均眼压与手术前平均眼压比较,差异均有统计学意义(F=6.88,P＜0.05).手术后3个月,发生继发性青光眼1只眼；此外无与治疗相关的其他并发症.结论微创玻璃体手术治疗脉络膜脱离型视网膜脱离有良好的临床疗效.
목적 관찰미창파리체절할수술치료맥락막탈리형시망막탈리적림상료효급안전성.방법 림상검사학진적맥락막탈리형시망막탈리환자35례36지안납입연구.기중,남성22례,녀성13례.평균년령(51.32±17.34)세.시력광감6지안；수동/안전자12지안；수지자9지안；0.01～0.1자8지안；0.2～0.3자1지안.평균최소분변각대수(LogMAR)시력위2.13±0.50.평균안압위(9.17±6.28) mm Hg(1 mm Hg=0.133 kPa).환자균행23G연합25G경결막무봉합파리체수술.수술중규유전충35지안,C3 F8전충1지안.수술후평균수방시간(6.23±3.07)개월.대비관찰수술전후시력、안압변화정황,이급수술후시망막복위솔、시망막탈리재발생솔급병발증등정황.결과 수술후1d,소유환안시망막균복위,점100.0％；수술후1개월,시망막복위33지안,점91.7％；시망막국한성탈리3지안,점8.3％,재차행공막구대수술,시망막복위.수술후3개월,시망막복위30지안,점83.3％.수술후1d,1、3개월평균LogMAR시력분별위1.77±0.66、1.53±0.72、1.31±0.77,여수술전평균LogMAR시력비교,차이유통계학의의(F=62.61,P＜0.05).수술후1d,1、3개월안압분별위(12.47±7.28)、(15.51±6.86)、(15.82±7.60) mm Hg(1 mmHg=0.133 kPa).수술후각시간점평균안압여수술전평균안압비교,차이균유통계학의의(F=6.88,P＜0.05).수술후3개월,발생계발성청광안1지안；차외무여치료상관적기타병발증.결론 미창파리체수술치료맥락막탈리형시망막탈리유량호적림상료효.
Objective To observe the efficacy and safety of micro-invasive vitrectomy for retinal detachment associated with choroidal detachment.Methods A total of 35 patients (36 eyes) with retinal detachment associated with choroidal detachment were enrolled in this study.The patients included 22 males and 13 females,with a mean age of (51.32±17.34) years.Visual acuity was light perception in six eyes,hand movement in 12 eyes,finger counting in nine eyes,0.01 - 0.1 in eight eyes,and 0.2 - 0.3 in one eye.The median LogMAR visual acuity was (2.13±0.50).The median intraocular pressure was (7.08±2.62) mm Hg (1 mm Hg=0.133 kPa).All the patients were received vitrectomy using 23-gauge instrumentation combined with 25-gauge infusion.Tamponade with silicone oil (35 eyes) or C3F8 gas (one eye) were performed.The median follow-up time was (6.23 ± 3.07) months.The pre-and post-operative visual acuity,intraocular pressure,the rate of retinal reattachment,the rate of recurrent retinal detachment and complications were comparatively analyzed.Results Retinal reattachment was attained in 36 eyes (100％) at the first day after vitrectomy.Retinal reattachment was attained in 33 eyes (91.7 ％) and recurrent retinal local detachment was attained in three eyes (8.3 ％) at one months after vitrectomy.The rate of retinal reattachment was 83.3％ (30 eyes) at three months after vitrectomy.One day,one and three months after treatment,the mean LogMAR visual acuity were 1.77±0.66,1.53±0.72,1.31±0.77 respectively.The differences of the visual acuity was statistically significant between before and after vitrectomy (F=62.61,P＜0.05).One day,one and three months after treatment,the mean intraocular pressure were (12.47±7.28),(15.51±6.86),(15.82±7.60) mm Hg respectively.The differences of the intraocular pressure was statistically significant between before and after vitrectomy (F=6.88,P＜0.05).Secondary glaucoma occurred in one eye at three months after vitrectomy.Except this,there was no other complication related to treatment.Conclusion Micro-invasive vitrectomy is a feasible and safe treatment for retinal detachment with choroidal detachment.