巩膜扣带联合注气术治疗玻璃体切除术后非增殖性视网膜脱离的临床分析

目的总结巩膜扣带联合玻璃体腔注气术治疗玻璃体切除术后非增殖性视网膜脱离的临床疗效。方法回顾性分析2007年1月至2011年12月收治的玻璃体切除术后非增殖性视网膜脱离7例患者，共7只眼行巩膜扣带联合玻璃体腔注气术。手术后随诊4～19个月，观察术后视网膜复位、术后视力恢复及并发症发生情况。结果所有7只眼治愈（100％），7例患眼视网膜裂孔均封闭，视网膜复位。2眼术后发现裂孔周围冷冻瘢形成不理想，于术后5～10d眼内气体填充状态下补充眼底激光治疗后裂孔封闭。1眼于扣带术后37d发现另一象限周边视网膜小裂孔，局限视网膜脱离经再次巩膜扣带联合玻璃体腔内注气术后，视网膜完全复位，未发生其他并发症。结论巩膜扣带联合玻璃体腔注气术治疗玻璃体切除术后非增殖性视网膜脱离，可避免再次玻璃体切除手术对眼内结构损伤，有利于视功能较快恢复，具有安全、有效、易于操作等特点，可作为治疗玻璃体切除术后非增殖性视网膜脱离的术式之一。

Scleral buckle combined with intravitreal gas injection for retinal detachment without proliferative vitreoretinopathy after vitrectomy

Objective To assess the therapeutic effect of scleral buckling combined with intravitreal gas injection on non-proliferative vitreoretinopathy retinal detachment after vitrectomy. Methods The clinical data of 7 patients （7 eyes）, with early non-proliferative vitreoretinopathy retinal detachment underwent scleral buckling procedure combined with intravitreal gas injection from January 2007 to December 201 l, were retrospectively reviewed. All 7 eyes had fresh retinal redetachment without proliferative vitreo-retinopathy （PVR） or development of proliferative membrane. Peripheral limited retinal redetachment not involving macular occurred in 4 eyes and retinal redetachment involving macular limited in the up half in 3 eyes. During the procedure, the hole was directly localized and frozen and the silicon sponge was sutured and pressed in the corresponding site. Meanwhile 0.3 - 0.6 ml ml pure C3F8 gas was injected vertically into vitreous cavity at 4mm behind the limbus. Results The operations were successful in all patients without any complications. Within the follow-ups, 7 eyes achieved completely retinal reattachment. In 2 eyes without ideal formation of freezing plaque around the holes, the retinal holes were sealed after laser therapy in 5 - 10 d after operation. A small peripheral hole was found in another quadrant retinal and reattachment was not achieved in 1 eye 37 d after operation. The patients receive the procedure again, and reattachment was achieved. Conclusion Intravitreal gas injection combined with scleral buckling surgery is safe and effective for patients with early retinal detachment without proliferative vitreo-retinopathy after vitrectomy.