Theodossiadis G, Chatzoulis D, Karantinos D, Maguritsas N
Arch Ophtalmol Rev Gen Ophtalmol. 1975 Aug-Sep;35(8-9):627-38.
This investigation is based on 262 cases of retinal detachment treated with episcleral silastic sponge implants and cryopexy. Anatomical restoration of the retina after one operation or more was successful in 89 percent. Drainage of subretinal fluid was carried out in 52 percent of the cases. Supplementary light-coagulation 3 or 4 weeks after the operation was applied in 43 cases (17 percent) in order to seal off retinal holes on the buckle due to inadequate chorioretinal adhesion following cryopexy. Insufficient adhesion was directly related to the retinal elevation in the area of the tear. Chorioretinal haemorrhages in the group without release of subretinal fluid were caused by the following factors: Repeated cryo-application in the same place, application of the probe on the open part of the tear instead of around the tear, sponge-fixation in the immediate area to vortex veins, pressure exerted by the sponge on choroidal and retinal vessels, particularly in persons of advanced age. Local haze of the vitreous corresponding to the location of the cryp-application was directly related to the number of applications and the position of the tear. Vitreous haze was more frequent where the hole was situated towards the ciliary body. Pigment migration was observed in 9 percent of the cases. It should be noted that this complication was also encountered preoperatively in a group amounting to 4 percent of the total number of cases after padding of the eyes and absorption of subretinal fluid. Such cases should be distinguished from those of postoperative occurrence of pigment migration. Detachment of the choroid happened more often in the group in which subretinal fluid was released. In this group expulsive haemorrhage also occurred, which, apart from the choroidal detachment, resulted, immediately upon drainage of subretinal fluid, in high intracular pressure. Macular puckering was noticed in 5 cases (2,7 percent). In 4 out of the 5 cases with this complication, the tear was located towards the posterior pole and sponge fixation was radial.
本研究基于262例采用巩膜外硅橡胶海绵植入联合冷冻疗法治疗的视网膜脱离病例。一次或多次手术后视网膜解剖复位成功的比例为89%。52%的病例进行了视网膜下液引流。术后3或4周，对43例（17%）患者进行了补充光凝，以封闭因冷冻疗法后脉络膜视网膜粘连不足而导致的巩膜扣带上的视网膜裂孔。粘连不足与裂孔区域的视网膜隆起直接相关。在未进行视网膜下液引流的组中，脉络膜视网膜出血由以下因素引起：在同一部位反复进行冷冻治疗；将探头应用于裂孔的开放部分而非裂孔周围；在紧邻涡静脉的区域固定海绵；海绵对脉络膜和视网膜血管施加压力，尤其是在老年患者中。与冷冻治疗部位相对应的玻璃体局部混浊与治疗次数和裂孔位置直接相关。当裂孔朝向睫状体时，玻璃体混浊更为常见。9%的病例观察到色素迁移。应当指出，在眼部包扎和视网膜下液吸收后，术前在占病例总数4%的一组患者中也出现了这种并发症。此类病例应与术后发生色素迁移的病例相区分。脉络膜脱离在进行视网膜下液引流的组中更为常见。在该组中还发生了驱逐性出血，除脉络膜脱离外，在视网膜下液引流后立即导致高眼压。5例（2.7%）患者出现黄斑皱缩。在出现这种并发症的5例患者中，有4例裂孔位于后极附近，且海绵固定呈放射状。
