玻璃体切割术治疗青少年非外伤性视网膜脱离的临床分析

发布时间：2018-02-24 16:34

本文关键词： 非外伤性视网膜脱离玻璃体切割术青少年　出处：《中南大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的观察青少年非外伤性视网膜脱离的临床特征及玻璃体切割术后的长期效果。方法回顾性系列病例研究。收集我院眼科2005年11月至2007年12月间因除外伤外视网膜脱离而接受经平坦部玻璃体切割术、年龄。718岁的49例(51眼)患者的临床资料,对其长期预后及相关影响因素等情况进行回顾性分析,并对其中有意义病例进行相关讨论。结果 1)在本组病例中,患者初诊年龄为6岁～18岁,以男性居多,男女比例约为3：1,高发年龄为16-18岁,占27.5%。 2)所有病例中,近视不伴其他病因12眼(23.5%),不明原因视网膜脱离17眼(33.3%),眼内炎5眼(9.8%),色素层炎5眼(9.8%),家族性渗出性玻璃体视网膜病变3眼(5.9%),黄斑前膜以及黄斑裂孔2眼(3.9%),Coats病2眼(3.9%),曾行眼前节手术(晶体抽吸术)2眼(3.9%),视网膜劈裂1眼(2.0%),视网膜静脉周围炎(Eales' disease)1眼(2.0%),以及Marfan综合征1眼(2.0%)。 3)至随访结束为止,视网膜解剖复位率为86.3%,仍有7例(13.7%)患眼眼内硅油未取出(即硅油眼)；共28例(54.9%)患眼术后视力较术前好转(P=0.003),38例(74.5%)患眼现矫正视力较术后视力有所提高(P=0.008)；共20例(39.2%)患眼发生并发症,其中并发性白内障居首位。 4)影响青少年玻璃体切割术后视网膜解剖复位以及视功能恢复的主要因素有增殖性玻璃体视网膜病变,晶体状态,初诊年龄,以及单纯孔源性视网膜脱离。结论 1.青少年非外伤性视网膜脱离的患者以男性居多,高发年龄为16-18岁,其中近视为主要病因。 2.经平坦部玻璃体切割术在治疗青少年非外伤性视网膜脱离时具有较高的成功率,但由于患儿的特殊性,手术的整体效果仍有待进一步提高,治疗方法以及术中硅油的使用也需进一步研究。 3.影响青少年玻璃体切割术后视网膜解剖复位以及视力恢复的主要因素有增殖性玻璃体视网膜病变,晶体状态,初诊年龄,以及单纯孔源性视网膜脱离(P0.05)
[Abstract]:Purpose. To observe the clinical features of juvenile non-traumatic retinal detachment and the long-term effect after vitrectomy. Method. A retrospective series of case studies. The clinical data of 49 patients (51 eyes) who underwent flat vitrectomy for retinal detachment except trauma from November 2005 to December 2007 in our hospital were collected. The long-term prognosis and related influencing factors were analyzed retrospectively, and the significant cases were discussed. Results. 1) in this group, the first diagnosis age is 6 years old to 18 years old, the male is the majority, the male / female ratio is about 3: 1, the high incidence age is 16-18 years old (27.555). 2) of all cases, Myopia was not associated with other etiology in 12 eyes (23. 5%), unexplained retinal detachment in 17 eyes (33. 3%), endophthalmitis in 5 eyes (9. 8%), pigmentositis in 5 eyes (9. 8%), familial exudative vitreoretinopathy in 3 eyes (5. 9%), macular membrane and macular hole in 2 eyes (3. 9%). There were 3. 9 eyes with anterior segment surgery (2 eyes with lens aspiration, 1 eye with retinal cleavage, 2 eyes with retinal vein perivenous inflammation, 2 eyes with Marfan's syndrome) and 2 eyes with Marfan syndrome (2 eyes) with anterior segment surgery (2 eyes), 1 eye with retinal fissure (2 eyes), 2 eyes with retinal vein perivenous inflammation (Eals' disease)1) and 2 eyes with Marfan syndrome. 3) until the end of the follow-up, The rate of retinal anatomical reattachment was 86.3%, and there were still 7 cases (13.7%). The intraocular silicone oil was not removed (I. E. Silicone oil eye; in 28 cases, it was 54.9). The postoperative visual acuity of the affected eyes was better than that of the preoperative improvement (P 0.003) in 38 cases (74.5%). The corrected visual acuity of the affected eyes was better than that of the postoperative visual acuity (P 0.008), and the complications occurred in 20 cases (39.2%). Among them, complicated cataract was the first. 4) the main factors affecting the anatomical reattachment of retina and the recovery of visual function after vitrectomy were proliferative vitreoretinopathy, lens state, age at first visit, and simple rhegmatogenous retinal detachment. Conclusion. 1. Most of the patients with non-traumatic retinal detachment were male, with a high incidence age of 16-18 years. Myopia was the main cause. 2.Transplanated vitrectomy has a high success rate in the treatment of juvenile non-traumatic retinal detachment. However, due to the particularity of the children, the overall effect of the operation still needs to be further improved. Treatment methods and the use of silicone oil during operation also need further study. 3. The main factors affecting the anatomical reattachment of retina and the recovery of visual acuity after vitrectomy were proliferative vitreoretinopathy, lens state, age at first visit, and pure rhegmatogenous retinal detachment (P0.05).
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R779.6

【参考文献】

玻璃体切割术治疗青少年非外伤性视 网膜脱离的临床分析

玻璃体切割术治疗青少年非外伤性视网膜脱离的临床分析