显微镜直视下巩膜外顶压及冷凝术治疗孔源性视网膜脱离

目的观察显微镜直视下巩膜外顶压及冷凝术治疗孔源性视网膜脱离的疗效。方法142例（142眼）孔源性视网膜脱离应用显微镜直视下用冷凝头顶压巩膜，确定裂孔及变性区的部位并冷凝，巩膜外加压，术中不引流视网膜下液，术后观察视力、眼压、视网膜复位情况。结果142眼全部一次视网膜完全复位，视网膜下液1d吸收者98眼，2～3d吸收者44眼，术后视力均有不同程度的提高。随访3～6月，复发1眼。结论显微镜直视下巩膜外顶压及冷凝术治疗原发性视网膜脱离，在成功封闭裂孔后，视网膜下液可自行吸收，可有效减少放液所带来的并发症，具有方便、准确、可靠的特点。

Treatment of rhegmatogenous retinal detachment with episcleral indentation and cryotherapy under surgical microscope

Objective To observe the curative effect of treating rhegmatogenous retinal detachment with episcleral indentation and cryotherapy under surgical microscope.Methods Episcleral indentation and cryotherapy under microscope were applied in 142 patients (142 eyes) with rhegmatogenous retinal detachment.The location of retinal breaks and degenerations were determined.Then cryotherapy and scleral encircling were performed without drainage the subrefinal fluid .Visual acuity,intraocular pressure and the condition of retinal reattachment were observed.Results All 142 eyes got complete retinal reattachment.Subretinal fluid of 98 eyes was absorbed on the first day,and that of the other 44 eyes was absorbed between 2 days and 3 days.All eyes' vision was improved after the operation to some degree.All the patients were followed up from 3 to 6 months,only one had a relapse.Conclusion When the hole is closed,the subretinal fluid can be absorbed in rhegmatogenous retinal detachment.The operation without drainage of the subretinal fluid not only has high rate of success but also can avoid the complications.It is also convenient,precise to perform retinal detachment surgery under microscope,and the therapeutic effect is reliable and satisfactory.