玻璃体切除联合不同睫状体复位术式的疗效观察
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Observation on the efficacy of vitrectomy combined with different surgical methods for cyclodialysis
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    摘要:

    目的:观察玻璃体切除联合两种睫状体复位缝合手术方法治疗复杂性睫状体脱离的临床疗效。

    方法:回顾42例42眼经B超及超声生物显微镜(ultrasound biomicroscopy,UBM)检查存在睫状体脱离(离断口范围≥60°),同时伴有晶状体、玻璃体、视网膜病变和眼外伤患者的临床资料。按照睫状体复位手术方式分为玻璃体切除联合睫状体巩膜间断缝合组20眼(A组)、玻璃体切除联合睫状体巩膜连续褥式缝合组22眼(B组)。A组首先间断缝合巩膜睫状体,然后进行玻璃体切除术。B组首先进行晶状体玻璃体切除术,然后由巩膜表面进针进入玻璃体腔内连续褥式缝合睫状体组织。观察术后最佳矫正视力、术后眼压情况、睫状体复位情况及两组患者睫状体复位手术时间,并进行统计分析。

    结果:两组患者术后视力及眼压情况差异无统计学意义(P>0.05),两组患者术后视力及眼压较术前差异有统计学意义(P<0.05),两组患者睫状体复位成功率(A组90%,B组86.36%)差异无统计学意义(P>0.05),两组患者睫状体复位手术时间差异有统计学意义(P<0.05)。

    结论:玻璃体切除联合两种术式复位缝合睫状体治疗复杂性睫状体脱离均安全有效,对于保留晶状体者适宜应用睫状体巩膜间断缝合方法,睫状体巩膜连续褥式缝合法适用于无晶状体眼、人工晶状体眼患者,对于广泛性睫状体脱离者更为简便。

    Abstract:

    AIM: To observe the clinical efficacy of vitrectomy combined with two surgical methods for the treatment of complex cyclodialysis.

    METHODS: The clinical data of 42 patients(42 eyes)with cyclodialysis(the range of fracture≥60°)accompanied by injured lens and vitreoretinopathy were retrospectively analyzed. They were all examined by B-ultrasound and ultrasound biomicroscopy(UBM)before surgeries. They were divided into group A(20 eyes)with vitrectomy combined with ciliary body scleral interrupted suture and group B(22 eyes)with vitrectomy combined with ciliary body scleral continuous mattress suture. In the group A, the suture was performed first, then the vitrectomy. In the group B, the lentectomy and vitrectomy were performed first, then the continuous mattress suture suture. Postoperative visual acuity, intraocular pressure(IOP), the condition of ciliary body reset and the suture time for ciliary body reset were observed and statistically analyzed.

    RESULTS: After operations, the visual acuity and IOP had no significant differences between the two groups(P>0.05). Visual acuity and the IOP significantly improved postoperatively compared with that preoperatively in both groups(P<0.05). There was no significant difference on the rate of ciliary body reset, which was 90% in group A and 86.36% in group B(P>0.05). The suture time for ciliary body reset had significant difference between the two groups(P<0.05).

    CONCLUSION: Vitrectomy combined with two different surgical methods for the complex cyclodialysis is safe and effective. For keeping the lens, it is appropriate to use interrupted suture method. Continuous mattress suture method is suitable for the pseudophakic or aphakic patients, especially with wide range cyclodialysis.

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刘芳.玻璃体切除联合不同睫状体复位术式的疗效观察.国际眼科杂志, 2016,16(3):502-504.

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  • 收稿日期:2015-12-02
  • 最后修改日期:2016-02-23
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  • 在线发布日期: 2016-03-02
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