不放液的节段性外垫压术与放液的巩膜环扎加压术的疗效比较

目的探讨不放液的节段性外垫压手术与放液的巩膜环扎加压术治疗孔源性视网膜脱离(RRD)的疗效,并对两种术式疗效进行比较。方法回顾分析181例(184只眼)增生性玻璃体视网膜病变(PVR)C2级以下改变的RRD行不放液的节段性外垫压手术与巩膜环扎加压、引流视网膜下液手术的临床资料。全部患者均为我院首诊病例,按手术中是否放液分为放液组和不放液组,分别分析各组PVR级别与视网膜解剖复位率的关系,并对二组的手术并发症、术后视力进行比较。181例患者术后随访时间2~48个月,平均8.6个月。结果放液组视网膜复位84只眼,手术成功率为91.3%;不放液组视网膜复位86只眼,手术成功率为93.5%。放液组和不放液组PVR不同级别(B,C级)视网膜复位率比较其差异无显著性意义(P>0.05)。而二组的手术并发症、术后视力进步率比较,不放液组手术并发症明显比放液组低,术后视力进步率较放液组高,其差别有显著性意义(P<0.01)。结论不放液的节段性外垫压手术与放液的巩膜环扎加压术复位率基本一致,但术后视力明显提高,手术并发症少,为手术步骤的重要改变,PVRC2级以下改变的RRD都可适用。

Scleral buckling procedure with or without drainage of subretinal fluid for rhegmatogenous retinal detachment

Objective To explore the therapeutic effect of operation between segmental buckling with nondrainage of subretinal fluid(SRF) and cerclage of scleral buckling with drainage of SRF for rhegmatogenous retinal detachment(RRD).To compare the therapeutic effect of the two operative Methods.Methods 181 patients underwent segmental buckling operation withnondrainage and cerclage of scleral buckling with drainage of SRF for RRD with proliferative vitreoretinopathy(PVR) less than C_2 and their clinical data were retrospectively analyzed.All patients were firstly treated in our hospital and divided into drainage group and nondrainage group.To analyse the relation-ship between the reattachment and the grade of PVR and to compare the complications and the improvement of postoperative vision.Follow-up ranged from 2 to 48 months.Results The rate of retinal reattachment was 91.3%(84/92) in drainage group and 93.5%(86/92)in nondrainage groupThere was no significant difference of rate of retinal reattachment between the two groups with different stages of PVR(stageB,C)(P>0.05),while the improvement of postoperative vision in nondrainge group was significantly higher than in drainge group and the complications was significantly lower(P<0.01).Conclusion The segmental buckling operation with nondrainage has the same rate of retinal reattachment as cerclage of scleral buckling with drainage of SRF,but it showed the higher improvement of postoperative vision and lower complications.It is suitable to RRD with PVR less than C_2 and is an important improvement of operating procedure.