Pagot V, Mathis A, Heldenbergh O, Idder A, Malecaze F
Service d'Ophtalmologie, CHU Rangueil, Toulouse.
J Fr Ophtalmol. 1992;15(11):587-91.
Examination of the extreme periphery of the fundus of patients with pseudophakic retinal detachment is difficult due to poor pupil dilatation, optical aberrations from the intraocular lens, opacification of the posterior capsule or peripheral capsular remnants. Fifty-one patients with pseudophakic retinal detachment were operated on with using the wide angle panfunduscope of Rodenstock. It allows a very satisfactory pre- or intraoperative view of the extreme periphery of the fundus using the slit-lamp of the operative microscope combined with a scleral indentation. In only 3 cases no break was found in spite of pre- and intraoperative examination of the fundus periphery with the panfunduscope. Anatomic success was achieved in 47 out of 48 patients with a minimum of 6 months of follow-up; 3 patients were lost to follow-up. The mean postoperative visual acuity was 0.5. Unlike other methods of fundus examination, such the 3 mirror Goldmann lens or the indirect binocular ophthalmoscope, the panfunduscope allows good visualization of the peripheral retina of patients with pseudophakic retinal detachment using the slit-lamp of the operative microscope combined with a scleral indentation. Thus, small peripheral retinal breaks, often associated with pseudophakic retinal detachment, can be identified.
由于瞳孔散大不佳、人工晶状体的光学像差、后囊混浊或周边囊膜残余,对人工晶状体眼视网膜脱离患者的眼底最周边部进行检查很困难。51例人工晶状体眼视网膜脱离患者使用罗敦司得广角全眼底镜进行手术。使用手术显微镜的裂隙灯结合巩膜压陷,它能提供非常满意的眼底最周边部的术前或术中视野。尽管术前和术中用全眼底镜检查了眼底周边部,但仅3例未发现裂孔。48例患者中47例获得了解剖学成功,随访至少6个月;3例失访。术后平均视力为0.5。与其他眼底检查方法不同,如三面镜戈德曼接触镜或间接双目检眼镜,全眼底镜使用手术显微镜的裂隙灯结合巩膜压陷,能很好地观察人工晶状体眼视网膜脱离患者的周边视网膜。因此,可以识别出常与人工晶状体眼视网膜脱离相关的周边小视网膜裂孔。