目的：观察巩膜外环扎术和巩膜外环扎联合巩膜外加压术对孔源性视网膜脱离(rhegmatogenous retinal detachment，RRD)患者眼球结构和眼压的影响。

方法：选取2014-05/2017-05在我院住院行手术治疗的RRD患者240例240眼，其中接受巩膜外环扎术100眼(巩膜外环扎术组)，接受巩膜外环扎联合巩膜外加压术140眼(联合组)。术前、术后2、4、12wk，检测眼压、角膜厚度、角膜水平和垂直曲率、前房深度、晶状体厚度、眼轴长度、睫状体厚度及小梁虹膜夹角度数。

结果：术后12wk，两组患者240眼均获得解剖复位。术后2wk，两组眼压、角膜厚度、角膜水平和垂直曲率、晶状体厚度、睫状体厚度均较术前显著增加，前房深度及小梁虹膜夹角度数均较术前明显减小，差异均有统计学意义(P<0.05)。两组患者术后视力均较术前改善，且术后2wk联合组视力明显优于巩膜外环扎术组，差异均有统计学意义(P<0.05)。

结论：巩膜外环扎术和巩膜外环扎联合巩膜外加压术对角膜、前房、房角、晶状体厚度及小梁虹膜夹角度数在早期均有显著影响，巩膜外环扎联合巩膜外加压术对眼压的影响时间长，应予以关注。

METHODS:In May 2014 to May 2017, 240 patients(240 eyes)with RRD were selected as research objects, in which 100 eyes(scleral cerclage group)were treated by scleral cerclage, 140 eyes(joint group)were treated by scleral cerclage combined external sclera pressure. Preoperative and postoperative 2, 4 and 12wk, intraocular pressure, corneal thickness and corneal horizontal and vertical curvature, anterior chamber depth, lens thickness and axial length, ciliary body thickness and the trabecular iris angle degree of two groups were detected.

RESULTS: At 12wk after surgery, all the 240 eyes got anatomical reattachment. Two weeks after surgery, intraocular pressure, corneal thickness, horizontal and vertical curvature of the cornea, lens thickness and ciliary body thickness increased significantly in both groups(P<0.05), and the anterior chamber depth and the degree of angle between the trabecular and iris decreased significantly(P<0.05). The postoperative visual acuity of the two groups was significantly better compared with that before surgery(P<0.05). The visual acuity of joint group was significantly better than that of the scleral cerclage group 2wk after surgery(P<0.05).

CONCLUSION: The scleral cerclage and external sclera cerclage combined with external sclera pressure on the cornea, anterior chamber, anterior chamber depth, lens thickness and degree of angle between the trabecular and iris were significantly influence in the early days. Effect of scleral cerclage combined with external sclera compression on intraocular pressure is longer, which should be paid attention to.