手术治疗高度近视眼黄斑裂孔视网膜脱离临床观察

目的评价高度近视眼黄斑裂孔视网膜脱离手术的成功率并分析有关因素。方法对15例高度近视眼黄斑裂孔视网膜脱离患者行玻璃体切除联合眼内填充18％C3F8或硅油手术。术后严格俯卧位至少2周以上。结果13只眼黄斑裂孔闭合视网膜复位，13只眼术后视力提高，2只眼术后视力无变化。术后主要并发症为晶状体核轻度硬化2只眼，眼压升高1只眼，纤维素性渗出2只眼，双眼复视1只眼。结论玻璃体切割联合眼内填充18％C3F8或硅油是治疗高度近视眼黄斑裂孔视网膜脱离安全有效的方法之一。术前详细检查眼底、正确设计手术方案及良好的手术技术是治疗本病的关键。

Clinical Observation of Surgical Treatment of Retinal Detachment due to Macular Hole in High Myopia

Objective To evaluate the successful rate of surgical treatment of retinal detachment due to macular hole in high myopia,and analyze the relative reasons. Methods 11 eyes of 15 high myopic patients with retinal detachment due to macular hole underwent vitrectomy combined with the adjunct of 18%C3F8 or silicone oil. Strict prone position was conducted at least 2 weeks postoperatively. Results Macular hole c,osed and retina reattached in 13 eyes. Visual acuity was increased in 13 eyes,and no change in 2 eye. Postoperative complications mainly included nuclear sclerosis of the lens（2 eyes ）, intraocular pressure elevation（ 1 eye）, fibrosis exudates（2 eyes ）, and diplopia（ 1 eye）. Conclusion The use of vitrectomy combined with the adjunct of 18% C3F8 or silicone oil is a safe and effective method in treating retinal detachment due to macular hole in high myopia. Preoperative careful examination of ocular fundus,rational surgical design,and better surgical expertise are basic factors in treating this disease.