玻璃体切除联合空气填充治疗下方裂孔的孔源性视网膜脱离的短期疗效

doi:10.13281/j.cnki.issn.1004-4469.2021.03.010

眼科 ›› 2021, Vol. 30 ›› Issue (3): 217-221.doi: 10.13281/j.cnki.issn.1004-4469.2021.03.010

玻璃体切除联合空气填充治疗下方裂孔的孔源性视网膜脱离的短期疗效

庄京京贺永宁罗玮唐瑞飞

爱尔眼科医院集团南京爱尔眼科医院眼底科，南京 210006

收稿日期:2021-02-04 出版日期:2021-05-25 发布日期:2021-06-09
通讯作者: 贺永宁，Email：heyn2017@126.com E-mail:heyn2017@126.com

Short-term efficacy of vitrectomy combined with air tamponade on rhegmatogenous retinal detachment with inferior holes

Zhuang Jingjing, He Yongning, Luo wei, Tang Ruifei

Department of Retinal and Vitreous Diseases, Nanjing Aier Hospital, Aier Medical Group, Nanjing 210006, China

Received:2021-02-04 Online:2021-05-25 Published:2021-06-09
Contact: He Yongning, Email: heyn2017@126.com E-mail:heyn2017@126.com

摘要/Abstract

摘要： 目的尝试应用玻璃体切除联合玻璃体腔空气填充治疗下方裂孔的孔源性视网膜脱离（RRD），观察其可行性。设计回顾性病例系列。研究对象 2017年6月至2020年10月间在南京爱尔眼科医院接受23G经睫状体平坦部三通道行微创玻璃体切除术（PPV）联合玻璃体腔无菌空气填充治疗的下方裂孔的RRD患者45例（45眼）。方法所有患者均行23G PPV手术，玻璃体切除后玻璃体腔单纯无菌空气填充。患者术前及术后5天、3周、3个月均行矫正视力、非接触眼压、裂隙灯检查、裂隙灯下眼底镜检查、广角眼底照相、相干光断层扫描（OCT）、眼科AB超、IOL-Master测眼轴长度等检查。观察术后视网膜一期复位率、最佳矫正视力（BCVA）、眼压及并发症情况。主要指标 视网膜一期复位率、BCVA、眼压及并发症情况。结果 1例患者在术后2个月时因局限性视网膜脱离行巩膜外加压术复位，余44例均一期复位，复位率97.8%，术后随访3个月均未发现再脱离。术前LogMAR BCVA为1.82±0.83，术后5天、3周，3个月分别为0.71±0.34、0.59±0.32、0.56±0.30，均较术前有显著提高（P均＜0.001）。随访期内，仅术后第1天有2例患者眼压升高，其余患者均未发现眼压升高及其他并发症发生。结论玻璃体切除联合玻璃体腔空气填充治疗下方孔源性视网膜脱离是一种可选择的经济有效的方法。（眼科，2021, 30： 217-221）

关键词: 视网膜脱离/外科学, 玻璃体切除术, 空气填充

Abstract: Objective To observe the short-term efficacy and feasibility of vitrectomy combined with air tamponade for rhegmatogenous retinal detachment (RRD) with inferior holes. Design Retrospective case series. Participants Forty-five patients with RRD with inferior holes who underwent pars plana vitrectomy（PPV）combined with air tamponade from June 2017 to October 2020 in Nanjing Aier Hospital. Methods All patients underwent 23-gauge vitrectomy combined with air tamponade. Best corrected visual acuity (BCVA), non-contact intraocular pressure (NCT), slit lamp microscope, indirect funduscopy with slit lamp, wide-angle fundus photography, optical coherence tomography (OCT), ophthalmic AB ultrasound examination and length of optic axis with IOL-Master were performed before surgery and 5 days, 3 weeks and 3 months postoperation. Retinal reattachment, BCVA, intraocular pressure (IOP) and complications were observed. Main Outcome Measures Retinal reattachment, BCVA, IOP and complications. Results Local retinal redetachment occurred in one patient at the second month after surgery. This patient underwent scleral buckling and got final reattachment. Initial reattachment was achieved 97.8% in the rest 44 patients in 3 months after surgery. No other patient suffered retinal redetachment during follow-up. Preoperative LogMAR BCVA was 1.82±0.83, and postoperative LogMAR BCVA was 0.71±0.34, 0.59±0.32, 0.56±0.30 respectively at 5 days, 3 weeks, and 3 months after surgery. All patients gained better postoperative BCVA. Increased IOP was found in two cases on the first postoperative day. Conclusion Vitrectomy combined with air tamponade is an effective treatment for RRD patients with well relaxed retina and closed inferior retinal holes. (Ophthalmol CHN, 2021, 30: 217-221)

Key words: retinal detachment/surgery, vitrectomy, air tamponade

庄京京贺永宁罗玮唐瑞飞. 玻璃体切除联合空气填充治疗下方裂孔的孔源性视网膜脱离的短期疗效[J]. 眼科, 2021, 30(3): 217-221.

Zhuang Jingjing, He Yongning, Luo wei, Tang Ruifei. Short-term efficacy of vitrectomy combined with air tamponade on rhegmatogenous retinal detachment with inferior holes[J]. Ophthalmology in China, 2021, 30(3): 217-221.

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玻璃体切除联合空气填充治疗下方裂孔的孔源性视网膜脱离的短期疗效

Short-term efficacy of vitrectomy combined with air tamponade on rhegmatogenous retinal detachment with inferior holes

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