巩膜外垫压术联合后巩膜加固术治疗高度近视孔源性视网膜脱离临床观察

发布时间：2018-09-08 12:39

【摘要】：目的观察巩膜外垫压术联合后巩膜加固术治疗高度近视孔源性视网膜脱离的安全性及疗效。方法高度近视眼孔源性视网膜脱离患者38例(38眼),均伴后巩膜葡萄肿,均接受巩膜外垫压术联合后巩膜加固术,观察联合手术的安全性及疗效。结果 36例1次复位成功,2例未复位,其中1例再次手术调整巩膜加压条带后复位,另1例行玻璃体切除联合硅油填充后视网膜复位。术后视力提高34例,无提高或下降4例,视力提高率89.5%。黄斑劈裂6例,其中劈裂腔完全消失4例,明显缩小2例。手术前后眼轴分别为(28.85±2.28)、(28.90±1.67)mm,屈光度分别为(-13.35±3.29)、(-13.62±3.26)D,手术前后眼轴和屈光度比较,P均0.05。38例患者均未出现眼内炎、眼内出血、医源性裂孔等严重并发症。结论巩膜外垫压术联合后巩膜加固术治疗伴后巩膜葡萄肿的高度近视孔源性视网膜脱离安全高、疗效好,同时避免了分期手术因粘连所致的操作困难。
[Abstract]:Objective to observe the safety and efficacy of scleral cushion combined with posterior scleral reinforcement in the treatment of high myopia with rhegmatogenous retinal detachment. Methods 38 cases (38 eyes) of ocular rhegmatogenous retinal detachment with high myopia were treated with posterior scleral grape swelling. Results 36 cases were successfully reattached in one time, 1 case was reattached after adjusting scleral compression band again, the other 1 case was treated with vitrectomy and silicone oil filled retina reattachment. Postoperative visual acuity was improved in 34 cases, no improvement or decrease in 4 cases, the improvement rate of visual acuity was 89.5%. Macular cleavage was found in 6 cases, of which 4 cases were completely disappeared and 2 cases were obviously reduced. The axial diopter of the eye was (28.85 卤2.28), (28.90 卤1.67) mm, before and after operation, and the diopter was (-13.35 卤3.29), (-13.62 卤3.26) D. there were no serious complications such as endophthalmitis, intraocular hemorrhage and iatrogenic hiatus in all the patients before and after operation (P = 0.05.38). Conclusion the treatment of high myopic rhegmatogenous retinal detachment with posterior scleral grape swelling by scleral cushion combined with posterior scleral reinforcement is safe and effective, and the difficulty of operation caused by adhesion in staging surgery is avoided.
【作者单位】：广西医科大学第一附属医院;郑州市第二人民医院;
【分类号】：R779.6

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