玻璃体切除术联合巩膜外环扎治疗脉络膜脱离型视网膜脱离
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摘要
目的:探讨玻璃体切除联术合巩膜外环扎治疗脉络膜脱离型视网膜脱离的临床疗效。方法:回顾性分析2014-01/2018-02在我院行玻璃体切除术联合巩膜外环扎治疗的脉络膜脱离型视网膜脱离患者19例19眼,术后3～12mo行玻璃体腔硅油取出术。观察患者术后视网膜复位率、眼压、视力恢复及并发症情况。结果:本组患者术后视网膜均复位,术后3mo患眼玻璃体腔硅油填充状态下眼压(16.09±3.58mmHg)、硅油取出术后6mo眼压(14.69±3.10mmHg)均高于术前(6.78±1.90mmHg)(均P<0.05)。硅油取出术后6mo,15眼患者视力较术前提高。术后无低眼压及眼球萎缩等并发症发生。结论:玻璃体切除术联合巩膜外环扎治疗脉络膜脱离型视网膜脱离是相对安全有效的,视网膜复位率高,术后并发症少,再次手术率低。
AIM: To investigate and analyze the safety and clinical efficacy vitrectomy combined with scleral buckling in treatment of rhegmatogenous retinal detachment associated with choroidal detachment.METHODS: Totally 19 patients(19 eyes) of rhegmatogenous retinal detachment associated with choroidal detachment treated by vitrectomy combined with scleral buckling in our hospital from January 2014 to September 2017 were retrospective analyzed.Silicone oil was removed from the vitreous cavity 3 to 12mo after operation.Retinal reattachment rate, intraocular pressure(IOP), visual acuity recovery and complications were observed.RESULTS:The IOP in vitreous cavity filled with silicone oil at 3mo after operation(16.09±3.58 mmHg) and 6mo after silicone oil removal(14.69±3.10 mmHg) were higher than those before operation(6.78±1.90 mmHg)(all P<0.05).Sixmonths after silicone oil removal, the visual acuity of 15 eyes was improved.No complications of low IOP and atrophy occurred after operation.CONCLUSION: Vitrectomy combined with scleral buckling is relatively safe and effective in treatment of rhegmatogenous retinal detachment associated with choroidal detachment, with high retinal reattachment rate, fewer complications and low reoperation rate.
AIM: To investigate and analyze the safety and clinical efficacy vitrectomy combined with scleral buckling in treatment of rhegmatogenous retinal detachment associated with choroidal detachment.METHODS: Totally 19 patients(19 eyes) of rhegmatogenous retinal detachment associated with choroidal detachment treated by vitrectomy combined with scleral buckling in our hospital from January 2014 to September 2017 were retrospective analyzed.Silicone oil was removed from the vitreous cavity 3 to 12mo after operation.Retinal reattachment rate, intraocular pressure(IOP), visual acuity recovery and complications were observed.RESULTS:The IOP in vitreous cavity filled with silicone oil at 3mo after operation(16.09±3.58 mmHg) and 6mo after silicone oil removal(14.69±3.10 mmHg) were higher than those before operation(6.78±1.90 mmHg)(all P<0.05).Sixmonths after silicone oil removal, the visual acuity of 15 eyes was improved.No complications of low IOP and atrophy occurred after operation.CONCLUSION: Vitrectomy combined with scleral buckling is relatively safe and effective in treatment of rhegmatogenous retinal detachment associated with choroidal detachment, with high retinal reattachment rate, fewer complications and low reoperation rate.
引文
1李凤鸣.中华眼科学.第2版.北京:人民卫生出版社2005:2191-2193
2 Li Z,Li Y,Huang X,et al.Quantitative analysis of rhegmatogenous retinal detachment associated with choroidal detachment in Chinese using UBM.Retina 2012;32(10):2020-2025
3 Rejdak R,Nowakowska D,Wrona K,et al.Outcomes of Vitrectomy in Pediatric Retinal Detachment with Proliferative Vitreoretinopathy.J Ophthalmol 2017;2017(2):1-6
4徐格致,江睿,吕嘉华,等.伴有脉络膜脱离的孔源性视网膜脱离的治疗.中国眼耳鼻喉科杂志2007;7(2):120-122
5段安丽,王宁利,王景昭.脉络膜脱离型视网膜脱离.国外医学眼科学分册 2005;29(4):279-283
6于文贞,孙摇遥,赵敏,等.玻璃体切割联合眼内硅油填充术治疗脉络膜脱离型视网膜脱离临床疗效观察.中国实用眼科杂志2012;30(2):137-140
7黄定国,陈伟奇,黄惠春.玻璃体切割联合硅油填充术治疗脉络膜脱离型视网膜脱离临床观察.中国实用眼科杂志 2016;34(6):589-592
8 Acar MA,ünlü N,Hazirolan D,et al.Conventional surgery for complicated retinal detachment in silicone oil-filled eyes.Eur J Ophthalmol 2011;21(3):290-295
9 Akkoyun I,Pinarci EY,Yesilirmak N,et al.Choroidal thickness after scleral buckling surgery in macula-off rhegmatogenous retinal detachment.Ophthalmologe 2014;111(10):954-960
10桂君民,王一.伴脉络膜脱离的原发性孔源性视网膜脱离术前局部和全身用皮质类固醇效果比较.第三军医大学学报 2007;11(29):1107-1109
11吴淑凤,李玉涛,刘淑伟,等.伴脉络膜脱离的黄斑裂孔性视网膜脱离术前皮质类固醇激素的治疗作用研究.中国实用眼科杂志 2009;27(2):137-139
12 Wei Y,Wang N,Chen F,et al.Vitrectomy combined with periocular/intravitreal injection of steroids for rhegmatogenous retinal detachment associated with choroidal detachment.Retina 2014;34(1):136-141
13魏勇,王润生,王睿,等.玻璃体切割联合球周及眼内注射曲安奈德治疗脉络膜脱离型视网膜脱离.中华眼底病杂志 2014;30(4):404-406
14毛剑波,吴素兰,陈亦棋,等.后Tenon囊下注射曲安奈德后行玻璃体切除术治疗脉络膜脱离型视网膜脱离的疗效观察.中华眼科杂志 2018;54(4):252-257
15 Yuksel-Elgin C,Elgin C.Intraocular pressure elevation after intravitreal triamcinolone acetonide injection:a Meta-analiysis.Int J Ophthalmol 2016;9(1):139-144
2 Li Z,Li Y,Huang X,et al.Quantitative analysis of rhegmatogenous retinal detachment associated with choroidal detachment in Chinese using UBM.Retina 2012;32(10):2020-2025
3 Rejdak R,Nowakowska D,Wrona K,et al.Outcomes of Vitrectomy in Pediatric Retinal Detachment with Proliferative Vitreoretinopathy.J Ophthalmol 2017;2017(2):1-6
4徐格致,江睿,吕嘉华,等.伴有脉络膜脱离的孔源性视网膜脱离的治疗.中国眼耳鼻喉科杂志2007;7(2):120-122
5段安丽,王宁利,王景昭.脉络膜脱离型视网膜脱离.国外医学眼科学分册 2005;29(4):279-283
6于文贞,孙摇遥,赵敏,等.玻璃体切割联合眼内硅油填充术治疗脉络膜脱离型视网膜脱离临床疗效观察.中国实用眼科杂志2012;30(2):137-140
7黄定国,陈伟奇,黄惠春.玻璃体切割联合硅油填充术治疗脉络膜脱离型视网膜脱离临床观察.中国实用眼科杂志 2016;34(6):589-592
8 Acar MA,ünlü N,Hazirolan D,et al.Conventional surgery for complicated retinal detachment in silicone oil-filled eyes.Eur J Ophthalmol 2011;21(3):290-295
9 Akkoyun I,Pinarci EY,Yesilirmak N,et al.Choroidal thickness after scleral buckling surgery in macula-off rhegmatogenous retinal detachment.Ophthalmologe 2014;111(10):954-960
10桂君民,王一.伴脉络膜脱离的原发性孔源性视网膜脱离术前局部和全身用皮质类固醇效果比较.第三军医大学学报 2007;11(29):1107-1109
11吴淑凤,李玉涛,刘淑伟,等.伴脉络膜脱离的黄斑裂孔性视网膜脱离术前皮质类固醇激素的治疗作用研究.中国实用眼科杂志 2009;27(2):137-139
12 Wei Y,Wang N,Chen F,et al.Vitrectomy combined with periocular/intravitreal injection of steroids for rhegmatogenous retinal detachment associated with choroidal detachment.Retina 2014;34(1):136-141
13魏勇,王润生,王睿,等.玻璃体切割联合球周及眼内注射曲安奈德治疗脉络膜脱离型视网膜脱离.中华眼底病杂志 2014;30(4):404-406
14毛剑波,吴素兰,陈亦棋,等.后Tenon囊下注射曲安奈德后行玻璃体切除术治疗脉络膜脱离型视网膜脱离的疗效观察.中华眼科杂志 2018;54(4):252-257
15 Yuksel-Elgin C,Elgin C.Intraocular pressure elevation after intravitreal triamcinolone acetonide injection:a Meta-analiysis.Int J Ophthalmol 2016;9(1):139-144