间接眼底镜下外路手术治疗孔源性视网膜脱离对患者视力与黄斑水肿的影响

摘要 目的：探讨间接眼底镜下外路手术治疗孔源性视网膜脱离对患者视力与黄斑水肿的影响。方法：选择2018年8月到2021年9月在本院诊治的孔源性视网膜脱离患者84例作为研究对象，根据1:1随机数字表法把患者分为眼底镜组与对照组各42例，对照组采用巩膜扣带术治疗，眼底镜组给予间接眼底镜下外路手术治疗，测定患者视力与黄斑水肿情况。结果：两组术后3个月的最佳矫正视力好于术前1 d，眼底镜组好于对照组（P<0.05）。眼底镜组术后3个月的总有效率为97.6 %，高于对照组的76.2 %（P<0.05）。眼底镜组术后3个月的眼内出血、视网膜坏死、眼内炎、高眼压等并发症发生率为4.8 %，低于对照组的23.8 %（P<0.05）。两组术后3个月的视网膜下液高度低于术前1 d，眼底镜组低于对照组（P<0.05）。眼底镜组术后3个月的自理等生活质量评分较对照组高（P<0.05）。结论：间接眼底镜下外路手术治疗孔源性视网膜脱离能改善黄斑水肿提高，促进恢复患者的视力，提高总体治疗效果，减少并发症，有利于患者视网膜下液高度降低，从而提高生活质量。

The Effects of External Surgical Treatment of Rhegmatogenous Retinal Detachment under Indirect Ophthalmoscope on Patients' Vision and Macular Edema

ABSTRACT Objective: To investigate the effects of external surgical treatment of rhegmatogenous retinal detachment under indirect ophthalmoscope on patients'' vision and macular edema. Methods: From August 2018 to September 2021, A total of 84 patients with rhegmatogenous retinal detachment who were diagnosed and treated in our hospital were selected as the research objects, and the patients were divided into the ophthalmoscope group and the control group with 42 cases each groups accorded to the 1:1 random number table method. The control group were treated with scleral buckling, and the ophthalmoscope group were treated with indirect ophthalmoscope external surgery, and the visual acuity and macular edema of the patients were measured. Results: The best corrected visual acuity of the two groups at 3 months after operation were better than that of the preoperative 1 day, and the ophthalmoscope group were better than the control group(P<0.05). The total effective rates in the ophthalmoscope group at 3 months after surgery were 97.6 %, which were higher than 76.2 % in the control group(P<0.05). The incidence of complications such as intraocular hemorrhage, retinal necrosis, endophthalmitis, and high intraocular pressure in the ophthalmoscope group were 4.8 %, which were lower than 23.8 % in the control group (P<0.05). The height of the subretinal fluid in the two groups at 3 months after operation were lower than the preoperative 1 day, and that in the ophthalmoscope group were lower than that in the control group(P<0.05). Fundus endoscopic group had higher quality of life scores such as self-care 3 months after operation than the control group(P<0.05). Conclusion: Indirect ophthalmoscope external surgical treatment of rhegmatogenous retinal detachment can improve macular edema, promote the restoration of patients'' vision, improve the overall treatment effect, reduce the occurrence of complications, and help reduce the height of the patient''s subretinal fluid, thereby improving the patient Quality of life.