Kono Toshihiro, Takesue Yoshiko, Shiga Sousuke
Department of Ophthalmology, Fukuoka University Chikushi Hospital, Chikushino, Japan.
Ophthalmologica. 2006;220(3):159-63. doi: 10.1159/000091758.
To evaluate scleral resection technique combined with vitrectomy for macular hole retinal detachment of highly myopic eyes.
Seventeencases (17 eyes) of macular hole retinal detachment in highly myopic eyes, in which the patient underwent vitrectomy combined with scleral resection technique formacular hole retinal detachment between January 1996 and December 2003 at Fukuoka University Chikushi Hospital, were studied. Following pars plana vitrectomy, as much as possible of the residual vitreous and/or epiretinal membrane was removed. A scleral resection was performed in 2 quadrants of the equatorial region of the temporal sclera. Finally, a fluid-air exchange with SF(6) gas injection was performed to achieve retinal attachment. Pre- and postoperative axial length of the eyeballs were measured by B-scan ultrasonography.
All cases had the retina reattached at the initial surgery, and visual acuities were stabilized or improved after the surgery. The posterior staphyloma became obscure in 13 out of 17 eyes (76.8%). The macular hole closed in 14 of 17 eyes (82.4%) ophthalmoscopically. There were no cases in which retinal redetachment occurred during follow-up periods of more than 6 months.
In cases of macular hole retinal detachment of a highly myopic eye, scleral resection technique combined with vitrectomy changed the shape of the eyeballs and allowed successful retinal reattachment at the initial surgery.
评估巩膜切除术联合玻璃体切除术治疗高度近视眼黄斑裂孔性视网膜脱离的效果。
对1996年1月至2003年12月在福冈大学筑紫医院接受玻璃体切除术联合巩膜切除术治疗高度近视眼黄斑裂孔性视网膜脱离的17例(17只眼)患者进行研究。在经平坦部玻璃体切除术后,尽可能清除残留的玻璃体和/或视网膜前膜。在颞侧巩膜赤道区的2个象限进行巩膜切除术。最后,进行液-气交换并注入SF(6)气体以实现视网膜复位。通过B超超声测量手术前后眼球的眼轴长度。
所有病例在初次手术时视网膜均复位,术后视力稳定或提高。17只眼中有13只眼(76.8%)的后巩膜葡萄肿变得不明显。眼底检查显示,17只眼中有14只眼(8)黄斑裂孔闭合。在超过6个月的随访期内,没有病例出现视网膜再次脱离。
对于高度近视眼黄斑裂孔性视网膜脱离病例,巩膜切除术联合玻璃体切除术改变了眼球形状,并在初次手术时成功实现视网膜复位。