巩膜扣带术联合氩激光光凝治疗视网膜脱离

目的 探讨将巩膜扣带术中冷凝改为术后氩激光光凝封闭裂孔,治疗视网膜脱离（retinal detachment,RD)的疗效及适应证范围。方法 回顾性分析1999年12月至2000年4月,在我院行巩膜扣带术接受氩激光光凝治疗的RD患者35例（38只眼）的临床资料。结果 术后随访3－6个月,38只眼中,视网膜完全复位36只眼（94．7％）。术后视力≥0。05者31只眼（86．1％）,最佳矫正视力为1．0。结论 将巩膜扣带术中冷凝改为术后氩激光光凝,可简化术中操作,减少视网膜和脉络膜血管的损伤及术后并发症的发生,是治疗RD的有效方法之一。     

巩膜扣带术联合氩激光治疗硅油眼视网膜再脱离

目的探讨巩膜扣带术联合氩激光光凝对硅油眼视网膜再脱离的治疗作用。方法对硅油眼视网膜再脱离患者行巩膜扣带术联合氩激光治疗的45例（45眼）进行回顾性分析。结果术后39眼视网膜复位,成功率86．67％,23眼（51．11％）视力提高。结论矾膜扣带术联合氩激光光凝是治疗硅油眼视网膜再脱离的有效手术方法之一,此手术方法经济、省时。     

视网膜脱离巩膜扣带术后激光光凝封闭裂孔

目的 评价巩膜扣带术后激光光凝封闭裂孔治疗视网膜脱离的效果.方法 回顾性分析2003年1月至2005年5月我科在巩膜扣带术后采用532nm激光经瞳孔光凝封闭裂孔治疗的原发性（孔源性）视网膜脱离35例（35眼）的临床资料,术后随访3～6月.结果 经一次治疗视网膜复位者33眼（94.29%）.结论 巩膜扣带术后激光光凝裂孔治疗原发性（孔源性）视网膜脱离,安全可靠,术后并发症少,是治疗视网膜脱离的一种有效方法.     

巩膜扣带术联合氪多波长激光光凝治疗视网膜脱离

目的 评价巩膜扣带术后限期应用双目间接眼底镜激光光凝封闭裂孔治疗视网膜脱离的疗效。方法 回顾性分析在我院行巩膜扣带术后接受氪激光光凝治疗的孔源性视网膜脱离患者39例(39只眼)的临床资料。结果 术后随访3～6个月，39只眼中，视网膜一次性复位36只眼(92．3％)。结论 巩膜扣带术后限期经光导双目间接眼底镜激光光凝治疗孔源性视网膜脱离，简便快捷、安全可靠，减少了术后并发症，是治疗孔源性视网膜脱离的有效方法之一。应用宽环扎，能更好的缓解玻璃体牵引；采用光导间接眼底镜进行光凝，可以减轻患者不适、对创口无污染、不压迫眼球。     

巩膜扣带术联合视网膜激光光凝治疗硅油填充眼复发性视网膜脱离

目的:探讨巩膜扣带术联合术后视网膜激光光凝治疗硅油填充眼复发性视网膜脱离的疗效。方法:回顾性研究。选取2019-03/2022-03就诊于大连市第三人民医院眼科一病房行巩膜扣带术联合术后视网膜激光光凝治疗硅油填充状态下视网膜脱离的患者23例23眼。比较手术前后最佳矫正视力(BVCA)、眼压、视网膜复位情况以及并发症。结果:末次随访时,23眼中20眼视网膜复位,复位率87%。术后3、6mo BCVA均较术前提高(均P<0.05)。术后早期眼压出现短暂升高后恢复术前水平。3眼出现硅油移位并发症,予以对症处理后前房完全由房水填充或前房残余少量硅油滴远离角膜内皮,对角膜内皮未造成不良影响。结论:巩膜扣带术联合视网膜激光光凝治疗硅油填充眼复发性视网膜脱离安全有效。     

光凝和冷凝封闭裂孔治疗原发性视网膜脱离的临床观察

目的评价激光光凝和冷凝封闭裂孔治疗原发性(孔源性)视网膜脱离的临床效果。方法回顾性分析2001年1月至2005年10月我科在巩膜扣带术后采用532nm激光经瞳孔光凝封闭裂孔的光凝组38例(38只眼)和冷凝封闭裂孔的冷凝组40例(40只眼)的原发性视网膜脱离的临床资料,随访6~12个月。结果出院时光凝组和冷凝组视网膜复位率无明显差异(P>0.05);随访期光凝组视网膜复位率、视力改善情况、PVR逆转率明显优于冷凝组(P<0.01)。结论巩膜扣带术后激光光凝封闭裂孔可减轻视网膜色素上皮的释放和血-视网膜屏障的破坏,逆转PVR的进程,减少术后复发率,是治疗原发性视网膜脱离的一种有效方法。     

光凝和冷凝治疗孔源性视网膜脱离的临床研究

目的：分析二极管激光光凝和冷凝在巩膜扣带术中治疗视网膜脱离的临床应用。方法：回顾分析1998年1月－1998年12月我科在巩膜扣带术中利用二级管激光封闭视网膜裂孔的光凝组30眼与冷凝封闭裂孔的冷凝组37眼的孔源性视网膜脱离患者的临床效果。结果：光凝组一次复位率100％。冷凝组一次复位率97．3％。术后视力改善光凝组25眼（83．83％）,凝凝组26眼（70．27％）。冷凝组术后出现5例黄斑部视网膜前膜。结论：二极管激光在巩膜扣带术中,治疗孔源性视网膜脱离和冷冻一样简单、有效。     

巩膜扣带术联合532间接眼底镜激光治疗孔源性视网膜脱离

目的 探讨将巩膜扣带术中冷凝改为间接眼底镜激光光凝封闭裂孔，治疗孔源性视网膜脱离的疗效和适应证范围。方法回顾性分析2003年12月～2005年4月在我院行巩膜扣带术接受532间接眼底镜激光光凝治疗RD患者26例（26眼）的临床资料。结果术后随访3～6个月，26眼中视网膜全部复位。结论将巩膜扣带术中的冷凝改为532间接眼底镜激光光凝可减少视网膜和脉络膜损伤及术中并发症发生，是治疗RD的有效方法之一。     

巩膜扣带术联合激光光凝术治疗视网膜脱离的效果观察

目的 观察巩膜扣带术联合激光光凝术治疗非复杂性孔源性视网膜脱离的疗效。方法 回顾性分析2003年1月-2005年9月我院行巩膜扣带术联合激光光凝术治疗的非复杂性孔源性视网膜脱离27例（28眼）。术后随访3-6月,观察视网膜复位情况,视力及并发症。结果 视网膜复位27眼（96.43%）,视力提高25眼,视力无改变2眼,下降1眼。结论 巩膜扣带术联合激光光凝术治疗非复杂性孔源性视网膜脱离效果满意。     

非凝固手术联合氪多波长激光治疗单纯孔源性视网膜脱离

目的：探讨将巩膜扣带术中冷凝改为术后氪多波长激光光凝封闭裂孔治疗视网膜脱离的疗效、适应证范围及临床意义。方法：回顾性分析2001／2003在我院行非凝固巩膜扣带手术联合术后氪多波长激光封闭裂孔治疗孔源性视网膜脱离36例(36眼)，观察其疗效并对结果进行评价。结果：术后随访3-24mo，视网膜完全复位的32例，术后0．5a后矫正视力≥0．132例，最佳矫正视力为1．5。结论：非凝固巩膜扣带术联合氪多波长激光治疗单纯孔源性视网膜脱离，简化了手术操作，无凝固手术相关的并发症，术后采用氪多波长激光封闭裂孔，可以根据裂孔的部位及届光介质混浊的程度选用不同波长的激光进行封孔，是治疗单纯孔源性视网膜脱离的有效方法之一。     

高度近视LASIK前孔源性局限性视网膜脱离的处理

目的 探讨高度近视眼LASIK术前孔源性局限性视网膜浅脱离的处理方法.方法 将拟行LASIK手术的高度近视合并孔源性局限性视网膜浅脱离患者32例32只眼,根据治疗方法不同分为3组,分别行单纯激光光凝、冷凝联合巩膜外加压和光凝联合巩膜外加压治疗,随访观察3～6 月,分析其疗效及相关并发症.结果 单纯激光光凝组治疗的有效率最低;冷凝联合巩膜外加压组治疗的有效率最高,但部分患者术后玻璃体混浊情况较术前加重;光凝联合巩膜外加压组治疗术后玻璃体混浊改变情况优于冷凝联合巩膜外加压组.结论 冷凝联合巩膜外加压仍是目前治疗高度近视眼LASIK术前孔源性局限性视网膜浅脱离疗效最确切的方法,单纯激光光凝或光凝联合巩膜外加压,是值得进一步研究的有效的替代手段.     

巩膜外垫压术处置视网膜激光光凝术治疗局限性孔源性视网膜脱离效果不佳病例的临床观察

目的 观察巩膜外垫压术对激光光凝效果不佳局限性孔源性视网膜脱离（RRD）患者的临床疗效。设计回顾性病例系列。研究对象2017年1月至2021年1月空军军医大学西京医院眼科就诊的既往视网膜激光光凝术治疗局限性RRD效果不佳患者19例（19眼）。方法所有患者均行巩膜外垫压术治疗,术后补充视网膜激光光凝。随访6个月～2年,观察治疗效果。主要指标术后视网膜复位情况、视力及并发症情况。结果19眼中,垫压术后视网膜完全复位17眼（89.5%）;2眼（10.5%）垫压嵴明确,但嵴上局部视网膜下存在积液,2周内视网膜下液完全吸收。2个月后2眼增生性玻璃体视网膜病变发生致视网膜脱离复发,均为首次激光后1周内行垫压术并术后2次补充激光光凝患者,行玻璃体切割硅油填充术后复位,后硅油取出稳定。末次随访时,视网膜复位19眼（100%）,其中经一次巩膜外垫压稳定17眼（89.5%）。17眼（89.5%）视力无明显变化;2眼（10.5%）视力下降。结论巩膜外垫压术处置视网膜激光光凝术治疗局限性RRD效果不佳患者远期疗效肯定。局限性RRD不恰当使用激光光凝非但无效,还会有一些负面影响,视网膜激光光凝斑密集、重复激光、...     

Postoperative laser coagulation as retinopexy in patients with rhegmatogenous retinal detachment treated with scleral buckling surgery: a prospective clinical study

PURPOSE: To evaluate postoperative laser photocoagulation as retinopexy mode in patients with rhegmatogenous retinal detachment treated with scleral buckling surgery. METHODS: The authors conducted a prospective feasibility study of consecutive patients with rhegmatogenous retinal detachment treated with scleral buckling surgery and postoperative laser during an 18-month period with a minimal follow-up of 6 months. Outcome measures were total retinal reattachment and the occurrence of proliferative vitreoretinopathy (PVR). RESULTS: A total of 123 patients (124 eyes) were included in this study. Seventy-six percent were phakic and 24% were pseudophakic. Fifty percent presented with one horseshoe tear, 15% with multiple tears, 30% with round breaks, and 5% with no identifiable break. Ten percent presented with a vitreous hemorrhage and 25% with three or four quadrants of detached retina. Six patients had PVR C1. Twelve patients required a postoperative gas injection, five patients received an additional buckle, and five patients underwent a vitrectomy, in four because of PVR. In all patients the retina was fully reattached at the end of follow-up. Planned postoperative laser coagulation took place 1 day to 10 weeks (median 3(1/2) weeks) after buckling surgery. Buckling material was removed in three patients without redetachment. CONCLUSION: Postoperative laser coagulation is a feasible alternative retinopexy mode in scleral buckling surgery, with encouraging anatomical results and a low incidence of PVR.     

Prediction of visual outcome after retinal detachment surgery using the Lotmar visometer

AIM: To evaluate whether an achromatic interferometer, the Lotmar visometer, is useful in predicting postoperative visual outcome in patients with primary rhegmatogenous retinal detachment (RD) involving the macula. METHODS: This prospective study included 40 eyes of 40 non-consecutive patients with macula-off RD. The eyes were phakic or pseudophakic, had a clear optical media, and had a measurable potential vision on preoperative visometric examination. Preoperative variables included Snellen visual acuity, duration of macular detachment, extent of RD, and visometric potential acuity. Reattachment surgery consisted of radial scleral buckling in 33 patients, circumferential scleral buckling and encircling in seven patients, and subretinal fluid drainage in 10 patients. Retinal breaks were treated with cryotherapy or laser photocoagulation. Patients were followed up for at least 6 months after uncomplicated surgery. Best corrected visual acuity measured at any time during follow up was correlated with the preoperative variables. RESULTS: Preoperative visual acuity was less than 20/200 in 37 (93%) of 40 patients. Potential visual acuity of 20/200 or better was measured using the Lotmar visometer in 37 patients (93%). Postoperative visual acuity was correlated significantly with duration of macular detachment (r=0.55; p<0.001), and extent of RD approached statistical significance (r=0.31; p=0.05). There was a higher correlation between postoperative visual acuity and the visometric measurements (r=0.61; p<0.001). CONCLUSIONS: The Lotmar visometer may be a valuable method to estimate visual outcome after uncomplicated scleral buckling surgery in patients with RD involving the macula.     

Laser interferometry: preoperative functional predictive value in retinal detachment

PURPOSE: To determine the functional predictive value of laser interferometry (LI) in retinal detachment (RD). METHODS: Laser interferometry with test field diameters of 3 degrees and 8 degrees, both with and without light, was tested preoperatively in 42 eyes with rhegmatogenous RD that were candidates for scleral buckling. Snellen visual acuity (VA) and LI (four test fields) were tested preoperatively and postoperatively (1 week, and 1, 3, and 7 months). Sensitivity and specificity of LI to predict postoperative (7 months after surgery) VA improvement was calculated. Chi-square and Spearman correlation tests were used for statistical analysis. RESULTS: Statistically significant Snellen VA improvement (P = 0.02) was first found 7 months after surgery. Laser interferometry at 3 degrees without light showed statistically significant improvement 3 months after surgery (P = 0.05). Laser interferometry at 3 degrees without light showed the highest sensitivity (93%) and specificity (87%) values. The best correlation between preoperative LI and postoperative Snellen VA (7 months after surgery) was also found with 3 degrees LI without light (r = 0.71, P = 0.002). CONCLUSION: Laser interferometry (3 degrees without light) was useful in predicting VA improvement in cases with RD preoperatively and postoperatively. Laser interferometry at 3 degrees without light showed the best correlation with postoperative Snellen VA.     

Phacoemulsification without intraocular lens implantation in patients with high myopia: long-term results

PURPOSE: To estimate the cumulative incidence of postoperative retinal detachment (RD), rhegmatogenous retinal lesions requiring argon laser treatments, anterior (ACO) and posterior (PCO) capsule opacification, and neodymium:YAG (Nd:YAG) laser capsulotomy in patients with high myopia who had phacoemulsification without intraocular lens (IOL) implantation. SETTING: Department of Ophthalmology and Neurosurgery, University of Siena, Siena, Italy. METHODS: Seventy-three eyes of 57 patients with high myopia who had phacoemulsification without IOL implantation from 1993 to 1996 were retrospectively reviewed. The mean postoperative follow-up was 62.3 months and the mean axial length, 30.22 mm (range 29.10 to 33.70 mm). The incidence of RD and preoperative and postoperative prophylactic argon laser photocoagulation for rhegmatogenous retinal lesions were assessed. Between 1997 and 2000, ACO was evaluated subjectively and PCO was evaluated using the EPCO photographic image-analysis system. The incidence of Nd:YAG laser capsulotomy was noted. RESULTS: Argon laser photocoagulation was performed in 8 eyes (10.9%) preoperatively and 3 eyes (4.1%) postoperatively. One RD (1.3%) was observed 26 months after surgery; no preoperative or postoperative prophylactic argon laser photocoagulation or Nd:YAG laser capsulotomy was performed in this eye. At 1 year, 49 eyes (67.1%) had mild ACO and 24 (32.8%) had anterior capsule fibrosis. The data did not change during subsequent follow-up visits. At 6 years, the mean PCO grade was 1.109 (range 0.972 to 2.931); an Nd:YAG laser capsulotomy was performed in 12 eyes (16.4%). CONCLUSIONS: Compared with other studies that evaluated the outcomes of highly myopic patients who had cataract surgery with posterior chamber IOL implantation, our patients, who did not have IOL implantation, had a lower incidence of postoperative rhegmatogenous retinal lesions requiring argon laser treatments and a similar incidence of postoperative RD and visually significant PCO.