巩膜扣带术治疗孔源性视网膜脱离

目的 观察巩膜扣带术治疗孔源性视网膜脱离的疗效。方法 160例（168眼）行巩膜扣带术，术中均在双目间接检眼镜直视下定位裂孔、冷凝封闭裂孔。术后随访，观察视网膜复位情况。结果 本组病例初次手术视网膜解剖复位率94．0％。二次巩膜扣带术后视网膜解剖复位率为97．6％。结论 巩膜扣带术是治疗孔源性视网膜脱离的有效方法。合理联合视网膜下液引流、玻璃体气体填充及眼底激光光凝可提高手术成功率。     

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。     

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.     

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。     

光凝和冷凝在孔源性视网膜脱离复位术中的对比应用

目的:比较光凝和冷凝在视网膜脱离复位术中的临床应用。方法:回顾分析2007-02/2009-08简单孔源性视网膜脱离复位术中应用术后光凝封闭裂孔42眼及术中冷凝封闭裂孔39眼的临床效果。结果:光凝组一次手术复位率为100%,冷凝组一次手术复位率为94.9%。术后视力改善光凝组为37眼(88%),冷凝组为29眼(74%),两组对视力的改善差异无统计学意义(P>0.05)。结论:巩膜外垫压联合术后激光也是治疗简单孔源性视网膜脱离的一种简单、有效的手术方式。     

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。     

巩膜扣带术治疗视网膜脱离118例临床分析

目的 对原发怍（孔源性）视网膜脱离行巩膜扣带术治疗并对其效果进行评价。方法 对118例118眼原发性视网膜脱离病人行巩膜扣带术治疗。术中直接检眼镜定位，放视网膜下液，巩膜外液氮冷凝，巩膜扣带或环扎术。结果 术后随访1周至半年，视网膜裂孔封闭、完全复位107眼（90．68％），视力提高90眼（76.27％）。结论 巩膜扣带术是治疗原发性视网膜脱离常用有效的方法。     

巩膜扣带术治疗陈旧性孔源性视网膜脱离

目的:观察巩膜扣带术治疗陈旧性孔源性视网膜脱离的疗效。方法:陈旧性孔源性视网膜脱离患者12例12眼,术前均在裂隙灯下用三面镜进行裂孔定位,术中均在显微镜下行巩膜扣带术,按术前裂孔的定位预置巩膜缝线,放出黏稠视网膜下液,冷凝封闭裂孔,预置缝线下植入硅胶,根据病情,部分患者植入环扎带,结扎缝线固定。术后随访,观察视网膜复位情况。结果:本组病例初次手术视网膜解剖复位率100%。结论:巩膜扣带术对于部分陈旧性孔源性视网膜脱离可以取得较好的效果。     

光凝与冷凝在孔源性视网膜脱离手术中的比较

目的　观察两种视网膜脱离手术的疗效并进行比较。方法　回顾分析 2 0 0 1年～ 2 0 0 2年因视网膜脱离行手术治疗的 30例病人。其中一组手术方式为巩膜扣带术联合术后激光治疗 ,另外一组为冷凝加巩膜扣带术 ,随访时间为 3个月至 1年。结果　两组视网膜复位率均为 88.6 7% ,差异无显著性 (P >0 .0 5 )。结论　巩膜扣带术联合术后激光治疗是治疗孔源性视网膜脱离的一种可行的方法 ,其疗效等同于传统的冷凝加巩膜扣带术。     

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、...     

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。     

最小量巩膜外垫压术治疗孔源性视网膜脱离的疗效分析

目的比较分析最小量巩膜外垫压术与巩膜环扎垫压术治疗孔源性视网膜脱离的疗效。方法回顾性分析2008年3月至2009年3月收治的20例（20只眼）孔源性视网膜脱离患者行最小量巩膜外垫压术（A组）的临床资料,并在同期住院行巩膜环扎垫压术的孔源性视网膜脱离患者中随机选择40例（40只眼）作为对照组（B组）,术后随访比较两组的视网膜复位率、最佳矫正视力及并发症情况。结果术后视网膜首次复位率A组为90％,B组为95％;最佳矫正视力A组为0．48±0．33,B组为0．48±0．28;增生性玻璃体视网膜病变（PVR）进展者A组占5％,B组占10％,两组间均没有显著差异（P=0．4642、0．9662、0．5089）。术后A组出现复视1只眼,B组出现短期高眼压3只眼,黄斑水肿1只眼,复视1只眼;两组术后屈光度的变化有显著差异（P=0．0019）,前房深度、眼轴长度及散光度的变化均没有显著差异（P=0．5444、0．8732、0．0582）。结论外加压手术是一种有效复位脱离视网膜的手术方式,最小量巩膜外垫压术对孔源性视网膜脱离能获得很好的疗效,而对眼球创伤小、仅改变眼局部形态结构,能避免传统巩膜环扎垫压术的一些并发症,但远期疗效还有待进一步观察。     

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.     

Late-onset retinal detachment associated with regressed retinopathy of prematurity

PURPOSE: To study the characteristics of late-onset retinal detachments in patients with regressed retinopathy of prematurity (ROP) and the condition of their fellow eyes. METHODS: We carried out a retrospective review of 29 patients (38 eyes) who had been treated at two institutions, one in the US and the other in Japan, between 1986 and 1997. The age at the time of treatment ranged from 6 to 51 years (mean=23.1). Five of the 38 eyes with tractional detachment were treated with either open-sky vitrectomy, closed vitrectomy, or scleral buckling; 27 of the 38 eyes with rhegmatogenous retinal detachment underwent scleral buckling or closed vitrectomy or both. The remaining 6 of the 38 eyes had subclinical rhegmatogenous detachment and were treated with photocoagulation or cryopexy, or followed without treatment. The most characteristic retinal breaks were multiple holes with a prevalence of equator and posterior types. RESULTS: Overall, anatomical reattachment was accomplished in 27/32 eyes (84%) that underwent surgery. Two thirds of the patients who underwent vitrectomy either initially or at a later time had poor postoperative visual acuity. More than half of the fellow eyes had retinal detachment and others had various characteristic fundus changes of regressed ROP. CONCLUSIONS: Long-term, probably life-long follow-up of high-risk patients is necessary so that diagnosis and treatment can be instituted at an early stage of retinal detachment.     

Anatomic and visual results in asymptomatic clinical rhegmatogenous retinal detachment repaired by scleral buckling

PURPOSE: To report presenting characteristics as well as anatomic and visual results in asymptomatic clinical rhegmatogenous retinal detachment repaired by scleral buckling. METHODS: Review of 28 eyes of 27 patients with an asymptomatic clinical retinal detachment-defined as a rhegmatogenous retinal detachment with subretinal fluid extending more than 2 disk diameters posterior to the equator-which were repaired by scleral buckling from January 1989 through December 1996 with follow-up of 6 months or longer. RESULTS: With a single scleral buckling procedure, anatomic reattachment of the retina occurred in all eyes; one eye redetached 14 months after the initial surgery secondary to a new retinal break and was successfully reattached. All eyes had best-corrected presenting and final visual acuity of 20/50 or better. Final best-corrected Snellen visual acuity was within 1 line of best-corrected presenting visual acuity in 82% of eyes; three eyes improved more than 1 line of Snellen visual acuity and two eyes lost more than 1 line. CONCLUSION: Anatomic and visual results in asymptomatic clinical rhegmatogenous retinal detachment after scleral buckling surgery are excellent. Strong consideration should be given to repair of these detachments.