CAJ | 학술논문

目的分析最小量巩膜外垫压术治疗孔源性视网膜脱离的效果.方法回顾分析162例(165只眼)孔源性视网膜脱离,均采用最小量巩膜外垫压术(即不放液,节段性巩膜外垫压术)治疗.术中不进行视网膜下液放液,只对视网膜裂孔进行冷凝及小范围的巩膜外垫压.结果术后视网膜复位156只眼(94.55％),154只眼l周内视网膜下液完全吸收.术后复位不良的9只眼中的4只眼上方球形视网膜脱离者辅以玻璃体腔气体填充(10％C3F8)后复位,4只眼行玻璃体切除术后视网膜解剖复位,另1只眼放弃治疗.最小量巩膜外垫压术并发症少,其中20只眼(12.12％)出现一过性高眼压,经局部或全身降眼压治疗,术后3～5d眼压恢复正常.均无眼内出血、感染或视网膜嵌顿发生.术后屈光状态随访3～6个月后接近术前.结论最小量巩膜外垫压术是一种不放液的、仅限于裂孔区的节段性巩膜外垫压手术,并发症少,二次手术率低,是值得推荐的经外路手术方式,对于玻璃体视网膜增生C1级以下的孔源性视网膜脱离及球形视网膜脱离均可以考虑该术式.
목적 분석최소량공막외점압술치료공원성시망막탈리적효과.방법 회고분석162례(165지안)공원성시망막탈리,균채용최소량공막외점압술(즉불방액,절단성공막외점압술)치료.술중불진행시망막하액방액,지대시망막렬공진행냉응급소범위적공막외점압.결과 술후시망막복위156지안(94.55％),154지안l주내시망막하액완전흡수.술후복위불량적9지안중적4지안상방구형시망막탈리자보이파리체강기체전충(10％C3F8)후복위,4지안행파리체절제술후시망막해부복위,령1지안방기치료.최소량공막외점압술병발증소,기중20지안(12.12％)출현일과성고안압,경국부혹전신강안압치료,술후3～5d안압회복정상.균무안내출혈、감염혹시망막감돈발생.술후굴광상태수방3～6개월후접근술전.결론 최소량공막외점압술시일충불방액적、부한우렬공구적절단성공막외점압수술,병발증소,이차수술솔저,시치득추천적경외로수술방식,대우파리체시망막증생C1급이하적공원성시망막탈리급구형시망막탈리균가이고필해술식.
Objective To analyse the clinical efficacy of the minimal scleral buckling surgery for rhegmatogenous retinal detachments(RRDs).Methods This retrospective study was performed on 165 eyes of 162 patients of rhegmatogenous retinal detachments (RRDs).All cases received the minimal scleral buckling surgery,which did not been perform subretinal fluid drainage and sclera buckling limited only to the area of retinal tears.Results In this research,Of the 165 eyes,retina in 156 eyes (94.55％) reattached after the surgery and the subretinal fluid in 154 eyes was completely absorbed within 1 week post operation.There were 4 eyes with superior globular retinal detachment reattached after pneumatic retinopexy,4 eyes with complicated retinal detachment were performed pars plana vitrectomy,another 1 patient gave up therapy.The results showed that complications of this surgery were rare.Some cases (20 eyes,12.12％) experienced transient high intraocular pressure and returned to normal after medical treatment in 3 to 5 days.There were no intraocular hemorrhage,infection or iatrogenic retinal incarceration.In 3 to 6 months post operation,the refractive state had no difference compared with preoperation.Conclusion the exocular minimal surgery is a kind of segmental buckling and nondrainage surgery.The complication is rare and reoperation rate is low,it is a reasonable surgery for retinal detachment.This surgery is primary suitable for globular rhegmatogenous retina detachment and those retinal detachment with PVR less then level C1.