Tian Chao-wei, Wang Yu-sheng, Yan Feng, Su Xiao-na
Department of Ophthalmology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
Zhonghua Yan Ke Za Zhi. 2009 May;45(5):402-5.
To evaluate the effects of scleral buckling combined with intravitreal gas injection for the treatment of retinal detachment in selected eyes which had undergone vitrectomy but without silicon oil tamponade.
This was a retrospective observational case series. Including 52 eyes of 52 selected patients. All patients had undergone vitrectomy without silicon oil tamponade as the first surgery for the treatment of various vitreoretinal diseases. After the failure of the first surgery, scleral buckling combined with intravitreal gas injection were performed for the treatment of retinal detachment in Xijing Hospital between January 2001 and May 2004. The scleral buckling was used in all surgeries and using radial placement of a silicon sponge or circumferential placement of solid silicon combined with an encircling band. During the surgery, all breaks were carefully marked to ensure they were on the crest or anterior slope of the buckle. Air or C(3)F(8) gas was injected intravitreously. The reattachment rate, visual outcome, and postoperative complications were investigated.
After a six-month to three-year follow-up period, the reattachment rate was 69.2% (36/52 cases). Further vitrectomy surgeries were needed for other 16 eyes. The visual acuity was improved in 32 eyes (61.5%), three eyes (23.1%) with no change, and 8 eyes (15.4%) decreased. Macular epiretinal membrane happened postoperatively in one eye, and cataract was found in another case. There is no serious complications.
Scleral buckling combined with intravitreal gas injection is an effective procedure for the treatment of retinal detachment in vitrectomized eyes without silicon oil tamponade. The rate of secondary vitrectomy also can be reduced.
评估巩膜扣带术联合玻璃体腔内注气术治疗部分已行玻璃体切除术但未行硅油填充的视网膜脱离患者的疗效。
这是一项回顾性观察病例系列研究。纳入52例患者的52只眼。所有患者均接受了玻璃体切除术且未行硅油填充,作为治疗各种玻璃体视网膜疾病的首次手术。首次手术失败后,于2001年1月至2004年5月在西京医院对视网膜脱离患者行巩膜扣带术联合玻璃体腔内注气术。所有手术均采用巩膜扣带术,采用放射状放置硅海绵或环形放置固体硅胶并联合环扎带。手术过程中,仔细标记所有裂孔,确保其位于扣带的嵴部或前坡。玻璃体腔内注入空气或C3F8气体。观察视网膜复位率、视力转归及术后并发症。
经过6个月至3年的随访期,视网膜复位率为69.2%(36/52例)。另外16只眼需要进一步行玻璃体切除术。32只眼(61.5%)视力提高,3只眼(23.1%)视力无变化,8只眼(15.4%)视力下降。术后1只眼发生黄斑视网膜前膜,另1例发现白内障。无严重并发症发生。
巩膜扣带术联合玻璃体腔内注气术是治疗未行硅油填充的玻璃体切除术后视网膜脱离的有效方法,还可降低二次玻璃体切除术的发生率。