微创结膜切口治疗孔源性视网膜脱离的临床优势分析

目的探求微创结膜切口行巩膜外垫压术治疗孔源性视网膜脱离的临床优势。方法选取我科2012年1月~2013年12月孔源性视网膜脱离患者164例164眼，按照随机数字表法分为实验组82例82眼和对照组82例82眼。实验组采用微创结膜切口行巩膜外垫压术，即在裂孔所在象限距角膜缘10 mm的位置，根据裂孔大小做平行或垂直角膜缘的结膜切口；对照组采用常规角膜缘结膜切口行巩膜外垫压术。随访观察两组术后眼底视网膜复位率、视功能恢复效果、视力提高程度、术后并发症的发生率，随访时间为6~24（10.5±2.0）个月。结果两组的平均住院时间、术中并发症发生率及平均住院时间相比较，实验组均较对照组明显下降（ P〈0.05）；两组术后的眼底视网膜复位率、视功能恢复情况及视力提高情况比较，实验组较对照组明显提高（P〈0.05）；并且实验组较对照组术后并发症明显减少（P〈0.05）。结论微创结膜切口行巩膜外垫压术治疗孔源性视网膜脱离效果较佳。

Analysis of clinical advantages of minimally invasive conjunctival incision in treatment of rhegmatogenous retinal detachment

Objective To explore the clinical advantages of minimally invasive conjunctival incision with scleral buckling in treatment of rhegmatogenous retinal detachment. Methods Total 164 eyes of 164 patients with rhegmatogenous retinal detachment receiving treatment in our hospital from Jan. of 2012 to Dec. of 2013 were selected and divided randomly into experimental group（ n=82 eyes of 82 patients）and conventional group（ n =82 eyes of 82 patients）according to the numeration table. The experimental group received minimally invasive conjunctival incision with scleral buckling,namely,conjunctival incision in parallel with or vertical to the corneal limb was made according to the size of the hole in the position 10 mm to the corneal limb in the quadrant where the hiatus was located;the conventional group received conventional corneal limbal conjunctival incision with scleral buckling. Follow-up observations were made on the retinal reattachment rate,recovery of visual function,visual acuity improved effect,and incidence rate of intraoperative complications of the patients in two groups. The follow-up time was 6-24 months,（10. 5 ± 2. 0）months averagely. Results The average hospitalization time,rate of operation complications and the average hospitalization time of the experimental group significantly decreased in comparison with the conventional group（P〈0. 05）;the retinal reattachment rate,recovery of visual function,visual acuity improved effect,and incidence rate of postoperative complications in the experimental group were improved significantly in comparison with the conventional group（ P 〈 0. 05 ）. Conclusion Minimally invasive conjunctival incision with scleral buckling for treatment of rhegmatogenous retinal detachment has better effects.