25G内定位联合微创巩膜外加压治疗孔源性视网膜脱离
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Clinical observation of minimally invasive scleral buckling combined with 25G in the treatment of rhegmatogenous retinal detachment
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    摘要:

    目的:观察Resight非接触广角镜辅助下25G光纤内照明联合微创巩膜外加压治疗孔源性视网膜脱离的临床效果。

    方法:回顾性分析2011-05/2015-03入院的视网膜脱离患者43例43眼,术前散瞳后前置镜、三面镜检查裂孔定位不明确,术中25G套管穿刺光纤内照明,Resight非接触广角镜下顶压查找裂孔,进行微创巩膜外加压。对所有患者在手术后第1wk,1、3、6mo各随访1次,采用手术前相同的设备和方法记录视力、眼压,观察视网膜复位和裂孔封闭情况。

    结果:所有患者中,41例41眼一次性复位,复位率为95.3%。1例1眼患者视网膜未完全复位,视网膜下积液残留,加压嵴位置欠佳,再次巩膜外加压手术复位; 1例1眼发生增殖性玻璃体视网膜病变(PVR)形成裂孔,采取玻璃体视网膜手术后完全复位。

    结论:对于术前检查裂孔不明确的视网膜脱离患者,采用25G内定位联合微创巩膜外加压术可以做到微创、定位准确,并可提高手术成功率。

    Abstract:

    AIM: To observe the clinical effects of minimally invasive scleral buckling combined with 25G cannula intra-optical fiber lighting in the treatment of rhegmatogenous retinal detachment with the help of non-contact wide angle lens.

    METHODS: We retrospectively analyzed 43 patients with rhegmatogenous retinal detachment from May 2011 to March 2015 in our hospital. The retinal tear locations of these patients analyzed preoperatively by pre-set lens and three-mirror contact-lens were uncertain. We detected the retinal tears intraoperatively by non-contact wide angle lens with the help of 25G cannula intra-optical fiber lighting. The tears were sealed by minimally invasive scleral buckling. The patients were followed up at 1wk, 1mo, 3mo and 6mo postoperatively. The vison and intraocular pressure were recorded with the same equipment and methods as preoperatively did. The retina reattachment and tear sealing status were also observed.

    RESULTS: The retina were reattached by one operation in 41 patients and the reattachment rate was 95.3%. One patient suffered from incomplete retina reattachment, effusion under the retina, poor position of compressed retinal area, and succeeded by minimally invasive scleral buckling once again. One patient developed new retina tear and completely reattached by vitrectomy.

    CONCLUSION:For those patients with uncertain retinal detachment preoperatively, minimally invasive scleral buckling combined with 25G cannula intra-optical fiber lighting could increase the success rate. The statistical analysis in large samples and the long-term complications should be further investigated.

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高荣玉,于春霞,黄旭东,等.25G内定位联合微创巩膜外加压治疗孔源性视网膜脱离.国际眼科杂志, 2019,19(12):2147-2149.

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  • 收稿日期:2019-07-11
  • 最后修改日期:2019-11-07
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  • 在线发布日期: 2019-11-21
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