玻璃体腔内注气治疗高度近视黄斑裂孔性视网膜脱离

目的：总结玻璃体腔内注气治疗高度近视黄斑裂孔性视网膜脱离的疗效。探讨该方法的适应证及相关因素。方法：２８例高度近视黄斑裂孔性视网膜脱离患者,经三种玻璃体腔内注气术,观察复位率、术前后视力变化及并发症情况。结果：２８例患眼,一次注气复位成功２１例（７５％）,复位眼视力７６．２％进步,２３．８％不变,无减退者,未出现严重并发症。结论：玻璃体腔内注气治疗高度近视黄斑裂孔性视网膜脱离。安全简便,可重复,不损伤残存视力,可作为该疾患的首选治疗方案。     

高度近视眼黄斑裂孔视网膜脱离手术治疗

目的评价高度近视眼黄斑裂孔视网膜脱离手术成功率,并分析有关因素。方法对11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10只眼黄斑裂孔闭合视网膜复位。10只眼术后视力提高,1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1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。术前详细检查眼底、正确设计手术方案及良好手术技术是治疗本病关键。(中华眼底病杂志,2001,17:90-92)     

巩膜环扎术联合玻璃体腔注气治疗黄斑裂孔性视网膜脱离疗效观察

目的：评价巩膜环扎术联合玻璃体腔注气在黄斑裂孔性视网膜脱离治疗中的价值。方法：对黄斑裂孔性视网膜脱离患者21例（22只眼）施行巩膜环扎术联合玻璃体腔内注气。全部病例随访3～12月。结果：18只眼一次或二次手术成功复位，占82％；4只眼分别在术后2～4个月后复发，其中2只眼再次手术后视网膜复位。2只眼未再手术。术后视力均较术前提高，无严重并发症。结论：巩膜环扎术联合玻璃体腔注气治疗黄斑裂孔性视网膜脱离安全、方便、有效。     

黄斑裂孔视网膜脱离手术疗效分析

目的 探讨黄斑裂孔视网膜脱离的手术方法,以提高手术成功率和疗效。方法 采用单纯注气术、环扎加压注气术、玻璃体切割联合手术,并对手术疗效进行统计、分析。结果 １１６例黄斑裂孔视网膜脱离手术,治愈９９例,治愈率为８４．５％,其中Ⅰ级膜治愈率１００％,Ⅱ级膜治愈率９２．５％。Ⅲ级膜治愈率７６．６％。结论 依据膜形成程度选择合适的手术方法,可提高手术成功率及术后视力。     

周边裂孔合并黄斑裂孔视网膜脱离的手术治疗

目的：探讨视网膜脱离继发黄斑裂孔的原因。手术方法,特点和疗效。方法：11例患者均在局麻下行常规视网膜脱离复位手术。间接检眼镜直视下冷冻周边裂孔,硅胶带环扎或外加压。放液,注气。结果：所有患者随访6月-2年,视网膜复位良好,黄斑孔贴附,最终视力均在0.02以上,其中≥0.05者9例,最好视力0.2。结论：视网膜脱离继发黄斑裂孔的形成可能与视网膜急性缺氧,黄斑囊变有关,手术关键是封闭周边裂孔,配合气体填充,术后黄斑孔不必激光封闭,此种手术方法简单,成功率高,术后视力能得到一定程度改善。     

玻璃体腔注气术治疗黄斑孔性视网膜脱离

目的 评价玻璃体腔注气术治疗黄斑孔性视网膜脱离的效果。方法 单纯性黄斑孔者行玻璃体腔注气或玻璃体切除加注气术，合并其它部位裂孔者，先采用常规凝因方法将这些裂孔封闭，再行玻璃体腔气体注入。结果 63例64眼黄斑裂孔性视网膜脱离，56眼黄斑孔闭合，治愈率87.5%。术后视力不同程度提高者46眼（71.8%）。结论 玻璃体腔注气治疗黄斑孔性视网膜脱离能使大部分病例（87.5%）获得治愈。     

黄斑裂孔合并周边裂孔视网膜脱离的手术治疗

黄斑裂孔特别是合并周边裂孔的视网膜脱离 ,由于手术方式选择不当可产生严重的增殖膜 ,裂孔不能有效封闭 ,不能有效的缓解牵引 ,往往导致手术的失败 ,本文总结了 40例黄斑裂孔合并周边裂孔视网膜脱离病例的治疗情况 ,分析如下。一、资料与方法1.对象 :本组患者均为黄斑裂孔合并周边裂孔视网膜脱离 ,共 40例 40眼 ,男性 2 5例 (占 6 2 .5 % ) ,女性 15例 (占37.5 % ) ,平均年龄 47.8岁 (2 3～ 72岁 )。病程 2周～ 12月 ,平均 6 2天 ,其中 <30天 12例 ,30～ 5 9天 11例 ,≥ 6 0天 17例。屈光状态 :正视眼 2眼 ,- 6 D以下近视 17眼 ,- 6 D以上…     

巩膜外加压联合玻璃体腔注气术治疗黄斑裂孔合并周边裂孔性视网膜脱离

目的 观察巩膜外加压联合玻璃体腔注气术治疗黄斑裂孔合并周边裂孔性视网膜脱离的疗效.方法 回顾性分析2004年1月至2009年12月因黄斑裂孔合并周边裂孔性视网膜脱离在我院就诊的42例患者,共42只眼,行巩膜外加压联合玻璃体腔注气术,手术后随诊1~12个月,观察术后视网膜复位、术后视力及并发症发生情况.结果 42只眼中3...     

玻璃体内空气填充治疗黄斑裂孔性视网膜脱离的远期疗效观察

目的评价玻璃体内空气填充治疗黄斑裂孔性视网膜脱离的远期疗效及适应症。方法单纯性黄斑裂孔者仅行玻璃体内空气注入；合并其他部位裂孔者，先采用常规凝固方法将这些裂孔封闭，再行玻璃体内空气注入。以单针法行气液交换，空气注入量不少于１．５毫升。结果出院时，９２．９％病例术后解剖学复位，７８眼随访６月～８年，８眼复发，复发率１０．３％。结论绝大部分黄斑裂孔性视网膜脱离病例（约９０％）行玻璃体内空气注入能获治愈。     

单纯巩膜外垫压术治疗黄斑裂孔性视网膜脱离

采用单纯巩膜外垫压术，治疗黄斑裂孔性视网膜脱离２８例，全部治愈。介绍了手术要点，讨论了本术式的构思，可行性和优点，术中不作热凝或冷凝，不放液，球内不注气，无需观察眼底，不仅缩短了手术时间，减轻了病人痛苦，重要的是避免了各种并发症的发生，有效地保护和提高视功能。     

C2F6气体在黄斑裂孔性视网膜脱离手术中的应用

目的 探讨Ｃ２Ｆ６气体在黄斑裂孔性视网膜脱离手术中的应用。方法 对２７例２８眼黄斑裂孔性视网膜脱离的患者进行玻璃体切割气液交换及效气体填充。结果 随访１～３个月总的 风膜复位率为８２．１％,３例视网膜未复位的原因为后巩膜葡萄肿较重,裂孔大致使裂孔周围的视网膜与脉络膜不能紧密相贴,２例再行硅油填充,视网膜复位良好,２７例２８眼手术后视力提高者２２眼,未变者５眼,下降１眼。结论 Ｃ２Ｆ６气体应用于黄斑     

玻璃体切割治疗黄斑裂孔性视网膜脱离

对２０例２０眼黄斑裂孔性视风膜脱离施行玻璃体切割术并进行１－４个月的随访。一次性手术后视网膜复位者１６眼，占８０％，二次手术后成功者２眼，手术后总愈率为９０％。术后视力均有改善，认为该手术不失为治疗黄斑裂孔性视网膜脱离的良好措施之一。     

Short-Acting Gas Tamponade with Strict Face-Down Posturing for the Treatment of Idiopathic Macular Hole

Purpose: A retrospective consecutive case series to evaluate the safety and efficacy of 25 gauge pars plana vitrectomy, ILM peeling, 20% SF₆ gas tamponade and strict posturing for the treatment of idiopathic full-thickness macular holes. Methods: We report the results of 106 consecutive eyes that underwent standard 25-gauge pars plana vitrectomy, brilliant peel-assisted internal limiting membrane peel, fluid:gas exchange with 20% SF₆ and strict posturing for one week. All patients were followed up at one week, one month, three months, and nine months postoperatively. Biomicroscopy at day 1 and biomicroscopy and OCT at week 1, months 1, 3, and 9 were used to assess macular hole status postoperatively. Pre- and postoperative logMAR visual acuity was compared. Results: The macular hole was closed in 102/106 eyes postoperatively (96.2%). Four eyes showed unclosed macular holes and underwent additional SF₆ intravitreal injection and strict posturing for 10 days. All macular holes were eventually closed without the need of a second surgical procedure. Mean visual acuity improved from 0.63 logMAR preoperatively to 0.39 logMAR postoperatively. One case of retinal toxicity was reported due to accidental intravitreal injection of antibiotic. Conclusions: 25-gauge vitrectomy, ILM peel, and short-acting gas tamponade are highly effective for the treatment of macular holes. Additional intravitreal gas injection followed by strict posturing seems to be a simple and effective treatment for unclosed holes.     

Surgical Removal of Retained Subfoveal Perfluorocarbon Liquid through a Therapeutic Macular Hole with Intravitreal PFCL Injection and Gas Tamponade

We report two cases of surgical removal of a retained subfoveal perfluorocarbon liquid (PFCL) bubble through a therapeutic macular hole combined with intravitreal PFCL injection and gas tamponade. Two patients underwent pars plana vitrectomy with PFCL injection for rhegmatogenous retinal detachment. In both cases, a retained subfoveal PFCL bubble was noticed postoperatively by funduscopy and optical coherence tomography. Both patients underwent surgical removal of the subfoveal PFCL through a therapeutic macular hole and gas tamponade. The therapeutic macular holes were completely closed by gas tamponade and the procedure yielded a good visual outcome (best-corrected visual acuity of 20 / 40 in both cases). In one case, additional intravitreal PFCL injection onto the macula reduced the size of the therapeutic macular hole and preserved the retinal structures in the macula. Surgical removal of a retained subfoveal PFCL bubble through a therapeutic macular hole combined with intravitreal PFCL injection and gas tamponade provides an effective treatment option.     

Macular Hole Formation in Rhegmatogenous Retinal Detachment after Scleral Buckling

Purpose

To describe early macular hole (MH) development in rhegmatogenous retinal detachment (RRD) after scleral buckling (SB) based on optical coherence tomography (OCT) findings.

Methods

The medical records and spectral domain OCT images of patients in whom MH developed after RRD repair were evaluated retrospectively.

Results

A postoperative MH was detected in five eyes that underwent SB during a 6-year period. All had fovea-off RRD without MH at the time of surgery. OCT showed partial loss of the inner retina with a preserved photoreceptor layer in early postoperative days. On average, 7 days (range,5 to 8 days) after surgery, outer retinal tissues disappeared, resulting in the full-thickness MH.

Conclusions

Serial OCT findings revealed that partial-thickness lamellar holes progressed to full-thickness MHs, which were formed by the degeneration of the outer retina in eyes with preceding loss of the glial cone in the fovea.     

Outcome and Significance of Silicone Oil Tamponade in Patients with Chronic Serous Retinal Detachment

Purpose

To evaluate the effectiveness of silicone oil tamponade in patients with chronic serous retinal detachment (SRD) persisting for three months after the resolution of ocular inflammation.

Methods

A total of 17 eyes of 17 patients diagnosed with chronic SRD persisting for three months after the resolution of ocular inflammation and with high risk of phthisis bulbi by secondary ocular hypotony and macular detachment by subretinal fibrous membrane formation were subjected to surgical intervention. Subjects underwent silicone oil tamponade after surgical drainage of subretinal fluid. Retrospective analyses on anatomical and functional success rates were then performed.

Results

Anatomical success with retinal reattachment was observed in ten of the 17 eyes (58.82%), while functional success measured as difference in the best-corrected visual acuity before and after the surgery were logarithm of the minimum angle of resolution (logMAR) 1.95 ± 0.66 and logMAR 1.51 ± 0.66, respectively (p < 0.05).

Conclusions

This study suggests that, in patients with chronic SRD despite prolonged medical treatment and resolution of inflammation, surgical drainage of subretinal fluid with silicone oil tamponade can achieve anatomical and functional success.     

黄斑裂孔视网膜脱离再手术分析

１９９０年１月至１９９５年１２月，我院黄斑裂孔视网膜脱离再手术的病例１２１眼，占同期黄斑裂孔视网膜脱离病人数的１８．０％。再手术原因以ＰＶＲ发展、黄斑孔周玻璃体视网膜牵引、后巩膜葡萄肿、黄斑区脉络膜萎缩斑为主；再次手术以玻璃体手术为主，总治愈率达８０．２％。手术后视力有明显提高。术后激光的使用对视力无明显影响。     

黄斑部硅胶加压术治疗黄斑裂孔视网膜脱离63例分析

以黄斑部硅胶加压术治疗黄斑裂孔视网膜脱离63例65眼,治愈率86%。此术通过黄斑部巩膜外加压块向眼内突起将黄斑裂孔顶住,促使黄斑裂孔的愈合,适用于黄斑部有皱襞及玻璃体牵引的黄斑裂孔病例。