巩膜扣带术联合23G玻璃体切割术治疗眼球内异物伴视网膜脱离
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摘要
目的:探讨巩膜扣带术结合23G玻璃体切割术对眼球内异物伴视网膜脱离的治疗效果。方法:将2014-01/2018-01收治的72例眼球内异物伴视网膜脱离患者以随机数字表法分为对照组36例和观察组36例,对照组行23G玻璃体切割术,观察组在对照组基础上行巩膜扣带术,观察两组术前、硅油取出3mo后眼压及视力变化、复位成功、复发情况及术后并发症发生情况。结果:术前两组眼压及BCVA均无差异(P>0.05),硅油取出后3mo,两组眼压及BCVA均较术前有明显改善(P<0.05),两组组间无差异(P>0.05);观察组与对照组一次手术解剖复位成功率分别为97%、81%(P<0.05),观察组与对照组复发率分别为6%、25%(P<0.05);观察组术后并发症发生率为22%,对照组31%(P>0.05)。结论:巩膜扣带术联合23G玻璃体切割术治疗眼球内异物伴视网膜脱离,可显著改善患者眼压及视力,提高复位成功率,减少复发,且安全性较高。
·AIM: To investigate the clinical effect of scleral buckling surgery combined with 23 G vitrectomy in treatment of intraocular foreign body with retinal detachment.·METHODS: Totally 72 cases of patients with intraocular foreign bodies and retinal detachment admitted from January 2014 to January 2018 were selected and divided into the control group(36 cases) and the observation group(36 cases) by random number table method. The patients in the control group were treated with 23 G vitrectomy surgery while patients in the observation group were treated with scleral buckling surgery on the basis of the treatment in the control group. The changes of intraocular pressure(IOP) and visual acuity, successful reset, recurrence and complications were observed before operation and 3 mo after silicone oil was removed.·RESULTS: There was no difference in IOP and BCVA between the two groups before operation(P>0.05). Three months after silicone oil was removed, IOP and BCVA in two groups were significantly improved compared with those before operation(P<0.05). There was no difference between the two groups(P>0.05). The success rates of one-time anatomical reduction in the observation group and the control group were respectively 97% and 81%(P<0.05). The recurrence rates of the observation group and the control group were respectively 6% and 25%(P<0.05). The incidence of complications was 22% in the observation group and 31% in the control group(P>0.05).·CONCLUSION: The treatment of scleral buckling combined with 23 G vitrectomy in the treatment of intraocular foreign body with retinal detachment can significantly improve the IOP and visual acuity of patients, improve the success rate of reduction, reduce recurrence, and have high safety.
·AIM: To investigate the clinical effect of scleral buckling surgery combined with 23 G vitrectomy in treatment of intraocular foreign body with retinal detachment.·METHODS: Totally 72 cases of patients with intraocular foreign bodies and retinal detachment admitted from January 2014 to January 2018 were selected and divided into the control group(36 cases) and the observation group(36 cases) by random number table method. The patients in the control group were treated with 23 G vitrectomy surgery while patients in the observation group were treated with scleral buckling surgery on the basis of the treatment in the control group. The changes of intraocular pressure(IOP) and visual acuity, successful reset, recurrence and complications were observed before operation and 3 mo after silicone oil was removed.·RESULTS: There was no difference in IOP and BCVA between the two groups before operation(P>0.05). Three months after silicone oil was removed, IOP and BCVA in two groups were significantly improved compared with those before operation(P<0.05). There was no difference between the two groups(P>0.05). The success rates of one-time anatomical reduction in the observation group and the control group were respectively 97% and 81%(P<0.05). The recurrence rates of the observation group and the control group were respectively 6% and 25%(P<0.05). The incidence of complications was 22% in the observation group and 31% in the control group(P>0.05).·CONCLUSION: The treatment of scleral buckling combined with 23 G vitrectomy in the treatment of intraocular foreign body with retinal detachment can significantly improve the IOP and visual acuity of patients, improve the success rate of reduction, reduce recurrence, and have high safety.
引文
1蔡春梅, 魏琳, 姜严明, 等.眼内异物手术治疗体会.中国实用眼科杂志2015;33(3):304-306
2杨婧, 陈松, 王昀, 等.巩膜扣带术治疗青年人孔源性视网膜脱离的疗效分析.中国实用眼科杂志2016;34(4):318-321
3张文文, 赵春淮, 孙林, 等.眼球内异物伤损伤机制及预后影响因素研究新进展.临床眼科杂志2015;23(3):280-283
4胡运韬, 马志中, 冯学峰, 等.球内异物临床特征的回顾性分析.中华眼视光学与视觉科学杂志2015;17(2):76-80
5杜伟, 解正高, 童俊, 等.后入路玻璃体切割术治疗眼球贯通伤伴球内异物.国际眼科杂志2017;17(7):1327-1329
6 Romano MR, Scotti F, Vinciguerra P.27-Gauge Vitrectomy for Primary Rhegmatogenous Retinal Detachment: Is it Feasible?. Ann Acad Med Singapore 2015;45(5):185-187
7孙好良, 刘金华, 黄敏丽, 等.23G玻璃体切割术联合巩膜扣带术在眼球内异物伴视网膜脱离中的临床疗效.广西医学2018;40(3):249-252
8吴敏, 胡竹林, 肖丽波, 等.23G微创玻璃体切除手术治疗球形视网膜脱离的疗效.实用医学杂志2015;31(6):972-974
9张来霞, 郝风芹, 李聪伶, 等.23 G微创玻璃体手术联合吊顶灯照明系统治疗复杂性外伤性视网膜脱离.眼科新进展2016;36(1):78-80
10陈忠平, 覃星妹, 张婷婷, 等.23G玻璃体切除术及硅油辅助取出眼内巨大异物的临床观察.国际眼科杂志2018;18(1):172-174
11周用谋, 李鑫, 黄继化, 等.传统20G与微创23G玻璃体切割术治疗视网膜脱离的早期疗效.安徽医学2015;36(10):1206-1208, 1209
12肖紫云, 李家璋, 宋秀胜, 等.玻璃体切割联合巩膜扣带术治疗复杂孔源性视网膜脱离的临床观察.福建医科大学学报2016;50(3):204-206
13 Ghasemi FK, Alemzadeh SA, Modarres M, et al. Scleral buckling surgery for rhegmatogenous retinal detachment with subretinal proliferation. Eye 2015;29(4):509-514
14朱磊, 李琳, 田晓燕, 等.巩膜扣带术后影响视网膜复位和视力恢复的相关因素分析.眼科新进展2017;37(2):167-171
15 Errera MH, Liyanage SE, Moya R, et al. Primary scleral buckling for pediatric rhegmatogenous retinal detachment. Retina 2015;35(7):1441-1449
2杨婧, 陈松, 王昀, 等.巩膜扣带术治疗青年人孔源性视网膜脱离的疗效分析.中国实用眼科杂志2016;34(4):318-321
3张文文, 赵春淮, 孙林, 等.眼球内异物伤损伤机制及预后影响因素研究新进展.临床眼科杂志2015;23(3):280-283
4胡运韬, 马志中, 冯学峰, 等.球内异物临床特征的回顾性分析.中华眼视光学与视觉科学杂志2015;17(2):76-80
5杜伟, 解正高, 童俊, 等.后入路玻璃体切割术治疗眼球贯通伤伴球内异物.国际眼科杂志2017;17(7):1327-1329
6 Romano MR, Scotti F, Vinciguerra P.27-Gauge Vitrectomy for Primary Rhegmatogenous Retinal Detachment: Is it Feasible?. Ann Acad Med Singapore 2015;45(5):185-187
7孙好良, 刘金华, 黄敏丽, 等.23G玻璃体切割术联合巩膜扣带术在眼球内异物伴视网膜脱离中的临床疗效.广西医学2018;40(3):249-252
8吴敏, 胡竹林, 肖丽波, 等.23G微创玻璃体切除手术治疗球形视网膜脱离的疗效.实用医学杂志2015;31(6):972-974
9张来霞, 郝风芹, 李聪伶, 等.23 G微创玻璃体手术联合吊顶灯照明系统治疗复杂性外伤性视网膜脱离.眼科新进展2016;36(1):78-80
10陈忠平, 覃星妹, 张婷婷, 等.23G玻璃体切除术及硅油辅助取出眼内巨大异物的临床观察.国际眼科杂志2018;18(1):172-174
11周用谋, 李鑫, 黄继化, 等.传统20G与微创23G玻璃体切割术治疗视网膜脱离的早期疗效.安徽医学2015;36(10):1206-1208, 1209
12肖紫云, 李家璋, 宋秀胜, 等.玻璃体切割联合巩膜扣带术治疗复杂孔源性视网膜脱离的临床观察.福建医科大学学报2016;50(3):204-206
13 Ghasemi FK, Alemzadeh SA, Modarres M, et al. Scleral buckling surgery for rhegmatogenous retinal detachment with subretinal proliferation. Eye 2015;29(4):509-514
14朱磊, 李琳, 田晓燕, 等.巩膜扣带术后影响视网膜复位和视力恢复的相关因素分析.眼科新进展2017;37(2):167-171
15 Errera MH, Liyanage SE, Moya R, et al. Primary scleral buckling for pediatric rhegmatogenous retinal detachment. Retina 2015;35(7):1441-1449