角巩膜破裂伤后视网膜脱离合并视网膜嵌顿的玻璃体手术方法探讨

目的:通过对101例角巩膜破裂伤后视网膜脱离合并视网膜嵌顿行玻璃体者的手术方法及效果的分析,探讨:(1)对视网膜嵌顿部是否一定行视网膜切开;(2) 在玻璃体切割眼是否还需要进行巩膜环扎术和外加压术. 方法:资料分为视网膜切开组和视网膜未切开组,比较两组的视网膜解剖复位率、硅油取出后视网膜最终复位率和视力改善情况,并分别在两组内比较行扣带术与未行扣带术病例的解剖复位率、硅油取出后视网膜最终复位率.结果:视网膜切开组的解剖复位率(85.2%)和最终复位率(59.0%)均高于视网膜未切开组;行巩膜扣带术的病例在视网膜切开组的最终复位率(83.3%)明显高于无扣带组.结论:开放性角巩膜破裂伤性视网膜脱离合并视网膜嵌顿需要行玻璃体手术时,应考虑视网膜切开松解嵌顿并联合巩膜扣带术,以比较彻底地松解缩短的视网膜.

Vitrectomy approach of retinal detachment with retinal incarceration after cornea-scleral laceration

Objective: To assess the necessity and effectiveness of the retinotomy for the site of retinal incarceration and the scleral buckling for vitrectomized eye in combined retinal detachment and retinal shortening after corneoscleral l aceration. Methods: Retinotomy group of 61 eyes was compared w ith nonretinotomy group of 40 eyes; in retinotomy group we compared 2 subgroups: scleral buckling in 69 eyes and no buckling in 32 eyes. The anatomic success rate and the final anatom ic success rate (after silicone oil removal) were used for the comparison. Resul ts: An anatomic retinal attachment rate of 85.2% and final attachment r ate of 59 .0% after silicone oil removal were observed in retinotomy group ,while an anato mic attac hment rate and final attachment rate of 36.3% in nonretinotomy gro up; the f inal attachment rate of 83.3% was observed in the group of retinotomy with buckl ing, whi le 33.3% in the group of retinotomy without buckling. Conclusion: The final reti nal attachment was higher in retinotomy group than that in nonretintomy group; s cleral buckling is necessary in retinal detachment with retinal incarceration.