球形孔源性视网膜脱离手术治疗的临床研究

Objective To investigate the effect of the improved drain-air-cryo- therapy-explants (DACE) operation method for bullous rhegmatogenous retinal detachment (BRRD). Methods The cases of 38 eyes in 38 patients with bullous rhegmatogenous retinal detachment who underwent surgery for the first time were reviewed retrospectively. Experimental group (Improved DACE) enrolled 22 cases (22 eyes) and control group (routine scleral buckling procedure) enrolled 16 cases (16 eyes). Surgical techniques: In the Experimental Group, applied the operating procedure of drainage and air injection first, then reregistered cryocoagulation, inflating or combine the cerclage. Pour gas via vitrectomy equipment. In the Control Group,applied the operating procedure of reregistering cryocoagulation, then inflating or combine the cerclage. All the cases were followed up 3～6 months. All the factors were observed with SPSS 13.0 statistical package,use Fisher,s exact test, the size of the test is a =0.05. Results The retinal reattached ratio of the single-operation and the last-operation: the Experimental Group was 90.9% (20/22) and 100.0% (22/22). The Control Group was 87.5% (14/16) and 93.8% (15/16),the distinction had no statistical significance (P =1.000 and P =0.421). The accurate ratio of hole/tear location: the Experimental Group was 95.5% (21/22), the Control Group was 62.5% (10/16), the distinction had statistical significance (P =0.028); The advanced ratio of the best corrected vision after the surgery: the Experimental Group was 77.3% (17/22),the Control Group was 56.3% (9/16),the distinction had no statistical significance (P =0.289); The postoperative complications: new hole/tear and cataract in the Experimental Group exceeded the Control Group,however,the retina reductus and PVR advancement were lower than the Control Group. Conclusions The improved DACE technique is a safe and effective method to treat the above tuberositas higher rhegmatogenous retinal detachment, with the characteristic of relatively stable intraocular tension duting the operation, exact hole/tear location, precise cryotherapy and etc.

Clinical study of surgery for bullous rhegmatogenous retinal detachment