近视性孔源性视网膜脱离288例临床疗效分析

目的:了解影响近视性孔源性视网膜脱离(RRD)手术治疗预后的因素,为临床治疗提供指导。方法:回顾性分析2007-04/2014-04我科收治并行手术的近视性RRD患者288眼(排除外伤、无晶状体眼、先天性疾患、牵拉性及渗出性视网膜脱离),统计手术解剖复位情况,分析裂孔大小、视网膜脱离时间长短对视力恢复和手术成功率的影响。结果:本文统计结果显示:一次性手术解剖复位245眼,复位率为85.1%,经二次、三次手术后总复位率为95.1%。近视程度及老龄因素对视网膜复位有影响:即近视程度高、年龄大的近视性RRD手术复位率低(P<0.05)。通过手术治疗,术后视力明显好于术前视力(P<0.01);近视程度高的RRD,术后视力恢复差(P<0.01),术后视力有提高的仅有152眼(52.9%),术后视力在0.05以上的有106眼。结论:手术是治疗近视性RRD的有效手段。年龄大的视网膜复位率低;近视程度高的视网膜脱离手术复位率低、术后视力恢复差;近视性孔源性视网膜脱离应重视视功能的恢复。

Healing effect analysis of rhegmatogenous retinal detachment in 288 myopic cases

AIM: To understand the prognostic factors of myopic rhegmatogenous retinal detachment(RRD)surgery, and provide guidance for clinical treatment.

METHODS: This retrospective study included 288 myopic RRD eyes(excluding trauma, aphakia, congenital diseases, tractional and exudative retinal detachment)from April 2007 to April 2014 in our department. The surgical anatomic reduction situation was statistically recorded, the effects of hole's size, retinal detachment duration on sight restoration and surgery success rate were analyzed

RESULTS:The statistical results showed that 245 eyes(85.1%)healed after their first operation, about 95.1% cases finally healed after their second or third operation. The degree of myopia and aging factor influenced the RRD operation: the higher degree and the older age were, the lower success rates were(P<0.05). Through surgery, postoperative visual acuity was significantly better than the preoperative ones(P<0.01). A higher degree of myopia RRD led to poor visual acuity(P<0.01). Postoperative visual acuity of 152 eyes(52.9%)were improved, of which 106 eyes' visual acuity was 0.05 or more.

CONCLUSION: Surgery is an effective means of treating myopic RRD. The older patients have lower success rates. A higher degree of myopia led lower reset rate after retinal detachment surgery and poor postoperative visual acuity. When treat myopic RRD, we should pay attention to the recovery of visual function.