玻璃体切割术联合视网膜光凝或内界膜剥除术治疗黄斑裂孔性视网膜脱离的疗效分析

目的 对比分析玻璃体切割术联合视网膜光凝或内界膜剥除术治疗黄斑裂孔性视网膜脱离的临床疗效.方法 回顾性分析我院2008年1月至2010年12月收治的黄斑裂孔性视网膜脱离患者64例(64眼)的临床资料,其中行玻璃体切割术联合视网膜光凝患者32例(联合光凝组),行玻璃体切割术联合内界膜剥除术患者32例(联合剥除组),术后随访6～24个月,观察两组患者随访末期视网膜复位情况、视力变化及并发症情况.结果 联合光凝组术后视网膜裂孔封闭、视网膜解剖复位率为59.4％,联合剥除组复位率为81.3％,差异有显著统计学意义(均为P＜0.01).2组术后视力均较术前明显提高,差异均有显著统计学意义(均为P ＜0.01),但联合剥除组术后视力恢复情况明显好于联合光凝组,差异有统计学意义(P＜0.05).联合光凝组并发症主要有视网膜轻度出血、继发性青光眼等,联合剥除组为术中轻度视网膜损伤、术后一过性高眼压等.结论 玻璃体切割联合内界膜剥除术治疗黄斑裂孔性视网膜脱离的临床疗效好于玻璃体切割联合视网膜光凝.

Curative effect comparison of vitrectomy combined with photocoagulation or internal limiting membrane peeling on macular hole retinal detachment

Objective To compare the clinical effect of vitrectomy combined with photo coagulation or internal limiting membrane peeling on macular hole retinal detachment.Methods The clinical data of 64 patients(64 eyes) with macular hole retinal detachment from January 2008 to December 2010 in our hospital were retrospectively analyzed,vitrectomy combined with photocoagulation was performed in 32 cases(photocoagulation group),and vitrectomy combined with internal limiting membrane peeling in other 32 cases(peeling group),the retinal reposition,visual acuity changes and complications were observed.Results The rate of retinal reposition in photocoagulation group and peeling group were 59.4%,81.3%,respectively,the difference was significant(P < 0.01).The postoperative visual acuity in two groups were better than pre-operation,there were significant differences(both P < 0.01),but the postoperative visual acuity in peeling group was better than that in photocoagulation group,there was statistical difference(P < 0.05).The complications in photocoagulation group included the slight retinal hemorrhage and secondary glaucoma,which in peeling group included the intra-operative slight retinal injury and postoperative transient high intraocular pressure.Conclusion The clinical effects of vitrectomy combined with internal limiting membrane peeling on macular hole retinal detachment are better than that of vitrectomy combined with photocoagulation.