目的:探讨双目间接眼底显微镜(binocular indirect ophthalmomicroscope,BIOM3)在玻璃体视网膜手术中的运用特点、优势、临床疗效和使用技巧。方法:应用BIOM3对126例126眼玻璃体视网膜病变患者实施玻璃体切割手术。观察手术时间、设备使用技巧、术中并发症、术后视力改善及并发症等。结果:手术时间44～92(平均55)min,并能在小瞳或屈光介质条件欠佳情况下,彻底地切除周边部及基底部玻璃体。术中并发症:2例术中玻璃体出血。术后随访3～10(平均4.5)mo。术后115眼(91.3%)视力均有不同程度的改善,视力≥0.3者12眼,～0.1者36眼,～0.01者45眼,<0.01者33眼。术后并发症:视网膜脱离复发5例,前房出血7例,继发性青光眼5例,增生性玻璃体视网膜病变2例。熟练掌握并总结了BIOM3的使用技巧。结论:BIOM3无需缝合金属固定环,节约手术时间,在无晶状体眼、气体或硅油填充、小瞳孔、不规则瞳孔及角膜病变时都得达到很好的全景和大景深的观察效果,易于基底部玻璃体彻底切除,此外还具有视野宽、立体感强、术者对术野整体把握度高等特点。

AIM:To discuss the effectiveness and techniques of vitrectomy using binocular indirect ophthalmomicroscope(BIOM3).METHODS:A retrospective study was carried on 126 patients(126 eyes) which were performed vitrectomy under BIOM3.The operation time,techniques of equipment using,intraoperative complication,postoperative visual acuity(VA) and complication were observed.RESULTS:Operation time was 44-92(mean 55) minutes.The postoperative follow-up time ranged from 3 to 10(mean 4.5) months.The postoperative visual acuity improved in varying degrees:VA≥0.3 in 12 eyes,0.3>VA≥0.1 in 36 eyes,0.1>VA≥0.01 in 45 eyes,VA<0.01 in 33 eyes.There was no severe complication during operation.5 retinal re-detachment cases,7 anterior chamber haemorrhage cases,5 secondary glaucoma cases and 2 proliferative vitreoretinopathy(PVR) cases were observed in follow-up after operation.BIOM3 application skills were introduced.CONCLUSION:We can get a good visualization and a wide field of retina in aphakia,gas-filled or silicone-filled eyes,small pupil and corneal diseases under BIOM3.BIOM3 is an excellent vitreoretinal surgical equipment with wild-angle viewing field and assistant-friendly advantages.

R779.6