重水硅油交换联合激光光凝治疗巨大裂孔视网膜脱离

目的总结巨大裂孔视网膜脱离手术治疗的经验及疗效.方法回顾性分析30例巨大裂孔视网膜脱离临床特征、手术方法及疗效.结果30例巨大裂孔视网膜脱离行巩膜环扎、玻璃体切割、剥膜、重水、激光光凝、重水硅油交换,其中5例联合晶体粉碎治疗,术后视网膜完全复位28例,部分复位2例,术后视力均有提高.手术并发症包括:术中重水进入视网膜下、脉络膜上腔硅油,术后硅油乳化、PVR复发、白内障.结论重水硅油交换联合激光光凝治疗巨大裂孔视网膜脱离可获满意疗效,硅油-重水交换具有阻止巨大裂孔后缘下滑作用,从而提高视网膜完全复位率.

Management of giant retinal tears with heavy water-silicone oil exchange and retinal photocoagulation

Objective:To report the experience of management of giant retinal tears with heavy water(perfluoro-carbon liquids)-silicone oil exchanged and endophotocoagulation.Methods:The clinical features,treatment tech-niques and outcome of thirty cases(30eyes)of giant retinal tears were analyzed retrospectively.Results:Thirty cas-es(30eyes)of giant retinal tears were treated with vitrectomy,peeling membrane,unfolding of the giant retinal tears by heavy water,endophotocoagulation,heavy water-silicone oil exchanging,scleral buckling;including5cases in combination with fragmentation.Postoperatively total retinal attachment was obtained in28(93.35%)of30eyes,vi-sual acuity improved in all cases.The complications of treatment included subretinal heavy water,subchoroidal sili-cone oil,lens opacity and emulsification of silicone oil.Conclusions:Surgical treatment of giant retinal tear yields good anatomical and functional results.Heavy water-silicone oil exchanging proves highly effective in preventing gi-ant retinal tears from falling.