【作者】 唐涵锋；

【导师】 徐国兴；

【作者基本信息】 福建医科大学 ， 眼科学， 2008， 硕士

【摘要】 目的:评价孔源性视网膜脱离(rhegmatogenous retinal detachment,RRD)手术治疗的临床疗效。方法:收集我院2006年1月1日至2007年12月31日RRD手术治疗患者202例214眼,手术采用单纯视网膜激光光凝术14眼、玻璃体联合视网膜手术56眼、视网膜下液放液术71眼、巩膜环扎术102眼、巩膜外加压术95眼、巩膜冷凝术116眼。术后随访平均6.个月。观察术后视力、裂孔封闭及视网膜复位情况,探讨RRD的临床特点、手术方法及适应证的选择,术中、术后并发症及处理。结果:1、术后视力提高171眼(79.9%),视力不变20眼(9.3%),视力下降23眼(10.7%)。2术后视网膜复位199眼(93.0%),复位失败15眼(7.0%),复发5眼(2.3 %)。3、术后并发症:屈光状态改变21眼(9.8%)、视网膜下液延迟吸收16眼(7.4%)、无菌性葡萄膜炎10眼(4.7%)、一过性高眼压9眼(4.2%)、角膜上皮水肿和混浊9眼(4.2%)、PVR加重7眼(3.3%)、视网膜面出血7眼(3.3%)、并发性白内障7眼(3.3%)、新裂孔形成5眼(2.3%)、眼球萎缩4眼(1.9%)。结论:1、根据RRD的不同情况选择不同的手术方式。2、完全封闭裂孔是手术治疗RRD的关键。3、RRD术后主要并发症为屈光状态改变、视网膜下液延迟吸收、无菌性葡萄膜炎、一过性高眼压、角膜上皮水肿和混浊。4、新裂孔形成是RRD术后复发的主要原因。5、视功能的恢复与脱离的范围、黄斑是否受累、脱离的时间等有关。更多还原

【Abstract】 Objective: To evaluate the effect of surgery in cases of rhegmatogenous retinal detachment.Method: 202 patients (214 eyes) with rhegmatogenous retinal detachment that underwent surgical management from January 2006 to December 2007 were involved in this retrospective studyResults: In all 214 eyes,14 eyes underwentsurgical management of endolaser retinal photocoagulation,56 eyes underwent surgical management of Vitreoretinal surgery,71 eyes underwent surgical management of the placement of liquid into the retina,102 eyes underwent surgical management of scleral encircling operation, 95 eyes underwent surgicalmanagement of scleral buckling procedure,116 eyes underwent surgicalmanagement of scleral cryotherapy.The mean months of follow up period is 6. To survey the visual acuity,the break and its closure on retina,and the situation of retinal detachment reduction,and to explore the clinical features of RRD, mechanism and indication of surgery,and complications during or after surgeryand how to deal with them. Results:1、Improved vision was observed in 171 eyes(79.9%),invariable vision was observed in 20 eyes(9.3%),and descended vision was observed in 23 eyes(10.7%).2、Retinal detachment reduction after operation was observed in 199 eyes(93.0%),and the failure of retinal detachment reduction was observed in 15 eyes. Complications after surgery:21 eye appeared the alteration of refractive status and in the follow-up period of 6 months they were rectified by optometry.16 eye appeared the slow absorption of liquid under the retina,and 1 or 2 weeks after surgery the liquid was absorbed by some treatments such as braking,body position to make sure the liquid was in the lowest position of the eye,and eating some traditional Chinese drugs curing RD.10 eyes appeared aseptic uveitis,and their situation were controlled by some treatments such as mydriatic and hormone.9 eyes appeared hypertonia oculi and the situation were controlled by systematical and local treatment.9eyes appeared opacity and edema of corneal epithelial cell and 1 weeks after surgery the cornea became transparent.PVR became more and more serious in 7 eyes. 7 eyes appeared the retinal hemorrhage,and 2 weeks they were absorbed by durgs.7eyes appeared the complicated cataract, and they can treated by cataract surgery in some time.New break occurred in 5 eyes,among which 4 eye underwent the secondary surgical intervene,and 1 eye was cured in the other hospital.2 eyes appeared atrophy of eye ball and underwent surgical management of enucleation and orbital implants.Conclusions: 1、To select different ways of surgery according to different situation of cases.2、Closing the break completely is the key point of the operation on RRD.3、The complications after surgery are the alteration of refractive status,slow absorption of liquid under the retina,aseptic uveitis,hypertonia oculi,and opacity and edema of corneal epithelial cell.4、The new break occurs are the main cause of the recurrence of RRD.5、There is conclusive relation in recovery of visual function with the abradant scope、to be involved in macula lutea or not、the time of detachment.更多还原