Schepens C L
Harvard Medical School, Boston, Mass.
Ophthalmic Surg. 1994 Jul;25(7):427-31.
I present what, in my opinion, is the optimal technique of managing primary simple retinal breaks and retinal detachment. For the preoperative examination, I recommend indirect stereoscopic ophthalmoscopy with scleral depression. The macula and suspected small peripheral breaks are studied with the biomicroscope and a three-mirror contact lens. Retinal breaks without retinal detachment are treated with cryotherapy if they are located anteriorly; with laser photocoagulation if they are posterior. Breaks with frank detachment can be treated with Lincoff's balloon, a procedure I prefer over pneumatic retinopexy. Multiple retinal breaks and those associated with fairly extensive chorioretinal degeneration are best treated with a permanent scleral buckling, the various modalities of which, along with their indications, I discuss in some detail.
我介绍一下我认为处理原发性单纯性视网膜裂孔和视网膜脱离的最佳技术。对于术前检查，我建议采用间接立体眼底镜检查并联合巩膜压迫法。使用生物显微镜和三面镜接触镜研究黄斑区及疑似周边小裂孔。无视网膜脱离的视网膜裂孔若位于前部，则采用冷冻疗法治疗；若位于后部，则采用激光光凝治疗。伴有明显视网膜脱离的裂孔可用林科夫球囊治疗，相较于气体性视网膜固定术，我更倾向于这种方法。多个视网膜裂孔以及那些伴有相当广泛脉络膜视网膜变性的裂孔，最好采用永久性巩膜扣带术治疗，我将详细讨论其各种方式及其适应证。
