准分子激光治疗近视亚临床视网膜脱离11例

目的 探讨亚临床视网膜脱离(subclinical retinal detachment,SCRD)的诊治及临床意义。方法 对预施PRK及LASICK术之前扩瞳三面镜查出有SCRD的患者随访6～15月,详细记录其诊治过程及预后。结果 共查1088眼,11眼伴有SCRD,占1.01％,随访8例患者均为单眼,其中正视眼1例,中低度近视2例,高度近视5例;采用保守治疗6例,其中2例网膜复位,4例视网膜脱离仍存;采用手术治疗2例,网膜复位;选择PRK 2例,1例行LASIK。结论 对于预施PRK及LASIK术的患者应详细检查眼底。一旦发现伴有SCRD,应及时采用保守治疗,定期随访,尽量避免网膜脱离复位手术。如需行近视手术应考虑手术的方法与时机。

Clinical management of subclinical retinal detachment before PRK or LASIK in myopia

Aim To probe into diagnosis, treatment as well as clinical implications of subclinical retinal detachment (SCRD). Methods Patients planned for PRK and LASIK were examined after pupil dilation with three-mirror microscope to identify SCRD. Cases of SCRD were followed up for 6-15 months. Results Among the 1088 eyes examined, 11 were accompanied with LASIK (1.08%). Among the 8 cases (8 eyes) followed up, 2 had low to medium myopia and 5 had high myopia. Retina was reattached in 2 of the 6 cases undergoing conservative therapy as well as in the 2 cases undergoing surgical treatment Later, PRK was performed on 2 cases and LASIL on 1. Conclusion Thorough fundal examination should be made for patients planned for PRK or LASIK. Once SCRD is diagnosed of, conservative therapy should start promptly and the follow-up should be made regularly. Surgery to reattach retina should be avoided at all possibility.