3种复杂性视网膜脱离行视网膜切开与切除术的临床对比研究
孙好良,刘金华,黄敏丽
(广西医科大学第一附属医院,广西 南宁,530021)
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摘要:
目的 比较3种不同原因所致的复杂性视网膜脱离通过视网膜切开与切除联合硅油填充治疗的临床疗效及其并发症情况。方法 回顾性分析2013年1月至2016年1月在广西医科大学第一附属医院眼科行玻璃体切割术治疗的复杂性视网膜脱离患者的病例。术中行视网膜切开术+硅油填充术的患者共40例(40 眼),按病因分为3组。A组:孔源性视网膜脱离患者15例;B组:眼球穿通伤伴或不伴眼球内异物致视网膜脱离13例;C组:糖尿病视网膜病变伴牵拉性视网膜脱离12例。所有患者在术中均行一定范围的视网膜切开与切除联合硅油填充,比较3组患者术后视网膜解剖复位成功率,术前及术后最佳 矫正视力(BCVA),术后各种并发症发生率。结果 术后随访6个月至12个月,术后视网膜总解剖复位37例,其中A组14例,B组11例,C组12例。手术前、后的视力比较,3组患者术后视力均较术前提高(P<0.05);3组之间术前与术后视力的差 值比较,差异无统计学意义(P>0.05)。手术相关并发症有白内障、低眼压、高眼压、术中眼内出血、重水残留、角膜带状变性,A组分别为11、4、6、3、2、2 例;B 组分别为8、5、3、5、2、2 例;C 组分别为10、2、4、6、1、1 例,此外,B组、C组各有术后眼内出血1例。结论 在各种原因所致复杂性视网膜脱离的病例中,行视网膜切开与切除术联合硅油填充均可获得较高的解剖复位成功 率,提高大部分患者的术后视力,术中及术后可能出现严重的并发症。
关键词:视网膜切开与切除;视网膜脱离;硅油;手术并发症
中图分类号:R779.6文献标志码:A文章编号:2096-1413(2017)05-0056-03
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