松弛性视网膜切开术治疗视网膜脱离合并严重前增殖性玻璃体视网膜病变

目的探讨松弛性周边视网膜切开术联合眼内激光治疗视网膜脱离合并严重前增殖性玻璃体视网膜病变的效果。方法对４４例视网膜脱离合并严重前增殖性玻璃体视网膜病变的患者行松弛性周边视网膜切开术，联合眼内激光和硅油填充治疗。观察术后视网膜解剖复位、视功能及术后眼压变化情况。其中２２例取出了硅油。结果４４例全部获得视网膜复位（其中８例合并皱褶），３８例获得不同程度的视力改善。２２例取出硅油后，有２１例视网膜保持复位。部分患者术后眼压偏低。１例患者黄斑移位。结论松弛性周边视网膜切开术是治疗严重前增殖性玻璃体视网膜病变的有效方法之一。视网膜下膜的清除有利于视网膜展平复位。部分患者出现术后眼压偏低和黄斑移位现象，因此应严格掌握手术适应证，术中尽可能避免黄斑移位，同时应在视网膜复位、眼压正常时再取出硅油。

Relaxing peripheral retinotomy with endolaser in treatment of retinal detachment with severe anterior proliferative vitreoretinopathy

Objective To investigate the effects of relaxing peripheral retinotomy with endolaser for treatment of complicated retinal detachment with severe anterior proliferative vitreoretinopathy. Methods 44 eyes of complicated retinal detachment with severe anterior proliferative vitreoretinopathy underwent relaxing peripheral retinotomy with endolaser treatment and silicone oil injection. Outcome measures included retinal reattachment, visual acuity, intraocular pressure as well as these after silicone oil removal. Results After minimum follow up of 3 months, the retina was completely attached in 44 eyes (8 of them with folds), 38 eyes achieved improvement of visual acuity. The silicone oil was removed in 22 eyes, the retina kept attached in 21 eyes of them. Hypotony (intraocular pressure <10 mmHg) was seen in 8 of the 22 eyes with reattached retina. Conclusion Relaxing peripheral retinopathy with endolaser in the surgery for complicated retinal detachment with severe anterior proliferative vitreoretinopathy is an effective procedure. Subretinal membrane peeling benefits a complete retinal reattachment. Hypotony occurred in some cases, therefore indications should be limited.