玻璃体手术治疗视网膜脱离合并脉络膜脱离

为了探讨玻璃体手术在视网膜脱离合并脉络膜脱离治疗中的应用，回顾性分析了12例12只眼视网膜脱离合并脉络膜脱离的病例，应用闭合式玻璃体手术，玻璃体腔内应用6mm长灌注针头，切除玻璃体，剥离视网膜前膜，气液交换，周边部下方裂孔置巩膜外填压，调整环扎带，玻璃体注气C3Fe15％。一例患者注入硅油。术前、术后常规全身激素用药。结果12例12只眼术中眼内压迅速重建，脉络膜下腔的液体经三个巩膜切口自行引流，脉络膜复位，无需另外的巩膜切口引流脉络膜下腔的液体，术后随访2～16个月，12只眼全部获得视网膜解剖复位，未诱发术后玻璃体视网膜增殖病变(PVR)。提示玻璃体手术在治疗视网膜脱离合并脉络膜脱离时是优先考虑的术式。

Par Plana Vitrectomy in the Treatment of Combined Rhegmatogenous Retinal Detachment and Choroidal Detachment

In order to investigate the application of par plana vitrectomy in the treatment of combined rhegmatogenous retinal detachment (RRD) and choroidal detachment (CD), 12 eyes of 12 cases of combined RRD and CD were retrospectively analyzed. Twelve eyes of 12 cases were subjected to par plana vitrectomy. Six mm infusion channels were used. Pars plana vitrectomy, membrane peeling and internal fluid-gas exchange with encircling scleral buckle placement were performed in a standard fashion. One patient received injection of silicone oil. Hormones were routinely administered pre and post operation. The results showed that the intraocular pressure was rapidly reconstructed in the 12 eyes of 12 cases, the fluid in the subchoroidal cavity was drained via the three sclera incisions. The detached choroidea replaced. No other sclera incision was needed to drain the fluid in the subchoroidal cavivity. The follow-up after operation lasted 2 to 16 months. The 12 eyes were replaced anatomically. No postoperative proliferation of vitreous body and retina was induced. It was suggested that par plana vitrectomy was the first choice in the treatment of CD combined with RCD.