关键词: 视网膜脱离/外科学, 巩膜外垫压, 视网膜激光光凝术

Abstract: Objective To observe the clinical effect of scleral buckling on localized rhegmatogenous retinal detachment (RRD) with poor results after retinal laser photocoagulation. Design Retrospective case series. Participants A total of 19 eyes of 19 patients with localized RRD with poor results after retinal laser photocoagulation who were treated with scleral buckling during January 2017 to January 2021 in the Ophthalmology Department of Xijing Hospital, Air Force Military Medical. Methods All patients were treated with scleral buckling and postoperative supplemental retinal laser photocoagulation. Follow-up from 6 months to 2 years to observe the therapeutic effect. Main Outcome Measures Retinal reattachment, visual acuity and other related complications after operation. Results The retina was reattached in 17 eyes (89.5%) after scleral buckling, the cristae was clear in 2 eyes (10.5%), but there was subretinal fluid under the cristae, and the subretinal fluid was completely absorbed within 2 weeks. Two months later, retinal detachment recurred due to proliferative vitreoretinopathy(PVR) in two eyes who need pars plana vitrectomy for retinal redetachment, both of them were patients who underwent scleral buckling within 1 week after the first laser and were supplemented with laser photocoagulation twice after operation. At the last follow-up, retinal reattachment was achieved in 19 eyes (100%), of which, 17 eyes (89.5%) were stable after scleral buckling. Visual acuity was obviously unchanged in 17 eyes (89.5%), and decreased in 2 eyes (10.5%). Conclusion The long-term efficacy of scleral bucking in the treatment of patients with poor outcomes after retinal laser photocoagulation for localized RRD is definited. The laser treatment for localized rhegmatogenous retinal detachment was not only ineffective, but also has many negative effects. The density of the laser spot, multiple laser photocoagulations, and a short period between laser photocoagulation and scleral buckling are potential factors in the recurrence of retinal detachment. (Ophthalmol CHN, 2022, 31: 364-368)

Key words: retinal detachment/surgery, scleral buckling, retinal laser photocoagulation