巩膜外垫压术治疗直肌下裂孔视网膜脱离的临床观察

目的观察巩膜外垫压术治疗直肌下裂孔引发的视网膜脱离的疗效，探讨其临床特点。设计回顾性病例系列。研究对象西京医院47例（47眼）裂孔位于直肌下的视网膜脱离患者。方法所有患者均行巩膜外垫压术治疗，术中采用硅胶海绵或硅胶轮胎在相应位垫压（或联合环扎），使裂孔位于垫压嵴上；部分病例联合消毒空气玻璃体内注入术。主要指标治疗前后视力变化、视网膜复位状况。结果手术后随访6个月-1年（平均7．3个月），一次手术后视网膜完全复位率为89．4％（42／47眼），好转率93．6％（44／47眼）；视力提高率为80．9％（38／47眼）。未见复视及眼球运动障碍等相关并发症。结论裂孔位于直肌下的视网膜脱离行巩膜外垫压（或联合环扎）术时有其特殊性，选择适当垫压材料、注重手术技巧以及精心操作，可获得较高的手术成功率，并可避免相关并发症的发生。

The therapeutic effects of scleral buckling on rhegmatogenous retinal detachment with the hole beneath the rectus

Objective To evaluate the therapeutic effects of scleral buckling on rhegmatogenous detachment of retina arised from the hole underneath the rectus. Design Retrospective case series. Participants 47 cases （47 eyes） from Department of Ophthalmology of Xijing Hospital were enrolled in the study, who suffered from rhegmatogenous retinal detachment with the hole underneath the rectus. Methods The seleral buckling was performed in all cases, including placement of a silicone sponge or circumferential placement of a solid silicone （or combined with encircling band）. All breaks were suited on the crest of buckle and the disinfectant air was injected intravitreously in some cases. Main Outcome Measures The visual acuity and the reattachment condition were recorded before and after operation. Results After a follow-up period of 6 to 12 months （average 7.3 months）, the reattaehment rate was 89.4% （42/47 cases） and the improvement rate was 93.6%（44/47 cases）, and 80.9%（38147 cases） patients got better visual acuity. While no complications, such as diplopia and defect of ocular movement, were observed in all cases. Conclusion There were some specialties of scleral buckling （or combined with encircling band） treatment for rhegmatogenous retinal detachment with the hole underneath the rectus. It is possible to achieve higher improvement ratio and avoid the complications if operation is performed carefully by choosing appropriate buckling material and using suitable skills.