改良式充气性视网膜固定术长期疗效分析

目的 比较改良式充气性视网膜同定术与常规巩膜扣带术治疗单纯孔源性视网膜脱离的长期疗效及并发症.方法 回顾性对比分析43例单纯性上方裂孔的孔源性视网膜脱离患者行改良式充气性视网膜同定术(PR)23例23只眼、常规巩膜扣带术(SB)20例20只眼治疗前后的临床资料.平均随访32月.结果 R组术后视力提高者19只眼(82.61%),SB组视力提高者19只眼(95.00%),两组之间差异没有统计学意义(x2=1.5985,P=0.2061).PR组16只眼经一次手术达到视网膜复位,占69.57%,SB组18只眼经一次手术达到视网膜复位,占90.00%,两组之间差异没有统计学意义(x2=2.6993,P=0.1004).两组最终手术复位率为100%.在圆形裂孔的病例中,PR组的一次手术复位率为86.67%(13/15).SB组的一次手术复位率为90.91%(10/11),两组之间差异没有统计学意义(x2=0.1119,P=0.7380).PR组并发症包括新裂孔形成(17.39%),视网膜下液(8.7%),增殖性玻璃体视网膜病变(4.35%),白内障(4.35%),与SB组相比均无统计学意义(P>0.05).结论 改良式充气性视网膜固定术治疗单纯性上方裂孔的视网膜脱离疗效确切,并发症少,在圆形裂孔的患者中可以达到与巩膜扣带术相同的疗效.

Long-term results of modified peneumatic retinopexy.

Objective To compare modified pneumatic retinopexy (PR) and conventional scleral buckling (SB) for repair of primary rhegmatogenous retinal detachment with respect to long-term effect and complications .Method Forty-three patients presention with retinal detachments, which retinal breaks located in the superior six clock hours of the ocular fundus, were repaired by either PR or SB, twenty-three patients inPR group and twenty patients in PR group.Comparative analysis of the clinical data in the two groups was made.An average follow-up of 32 months was obained.Results Best-corrected visual acuity of 19 eye simproved two lines and more in PR group.The overall reattachment rate with reoperation in both groups was 100% .In cases of patients only with superior retinal hole,86.67% single-procedure reattachment rate was achieved in PR group ,and 90.91% in SB group.Complications in PR group included new and missed retinal breaks,delayed absorption of subretinal fluid,PVR and cataract .No Significant difference was found in best-corrected visual acuity, single-procedure reattachment rate and complications between PR group and SB group.Conclusions Modified pneumatic retinopexy is an effective and safe surgery for retinal detachments with superior breaks.In cases of patients only with superior retinal hole,pneumatic rctinopexy can reach the same therapeutic effect of scleral buckling.