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玻璃体视网膜手术治疗先天性视网膜劈裂及其并发症的临床疗效
引用本文:王晓莉,王大庆,张键,邓智会,陈晓丽.玻璃体视网膜手术治疗先天性视网膜劈裂及其并发症的临床疗效[J].现代生物医学进展,2015,15(11):2128-2130.
作者姓名:王晓莉  王大庆  张键  邓智会  陈晓丽
作者单位:四川省简阳市人民医院眼科;川北医学院附属医院眼科
摘    要:目的:评价玻璃体视网膜手术治疗先天性视网膜劈裂及其并发症的临床疗效。方法:选择2009年1月-2012年1月于我院进行玻璃体视网膜手术的先天性视网膜劈裂患者30例(42只眼),患者均接受了闭合式睫状体经扁平部三切口入路保留晶状体的玻璃体切割手术,并分析其术前及术后情况。结果:先天性视网膜劈裂患者中发生孔源性视网膜脱离19眼,牵拉性视网膜脱离8眼,玻璃体积血10眼,同时伴有视网膜脱离和玻璃体积血有5眼;在末次随访时视力提高者有36只眼,占85.71%,无提高者有6只眼,占14.29%;术前平均视力为(0.15±0.09),末次随访时平均视力提高至(0.31±0.16),两者平均视力差异具有统计学意义(t=5.649,P0.001);42只眼视网膜解剖结构复位良好,视网膜平伏;OCT检查结果显示,末次随访时黄斑劈裂平均面积(0.22±0.18)mm2,与术前黄斑劈裂平均面积(1.07±0.52)mm2比较,差异有统计学意义(t=10.011,P0.001),黄斑微囊样改变有改善;随访期间5只眼出现并发症,占11.90%,其中2眼术后发生PVR且伴牵拉性视网膜脱离,2只眼发生白内障,1只眼出现玻璃体积血,术后视网膜解剖均复位良好。结论:玻璃体视网膜手术可以帮助患者进行视网膜解剖复位及提高其先天性视网膜劈裂患者视功能,具有良好的临床疗效。

关 键 词:先天性视网膜劈裂  并发症  玻璃体视网膜手术  治疗结果

Clinical Efficacy of Vitreoretinal Surgery for Congenital Retinoschisis and its Complication
Abstract:Objective:To evaluate the clinical efficacy of vitreoretinal surgery for congenital retinoschisis and its complications.Methods:30 congenital retinoschisis patients (42 eyes) were treated by vitreoretinal surgery from January 2009 to January 2012 and underwent a standard three-port pars plana vitrectomy, the preoperative and postoperative conditions were analyzed.Results:Among the eyes, there were 19 eyes with rhegmatogenous retinal detachment, 8 eyes with traction retinal detachment, 10 eyes with vitreous hemorrhage and 5 eyes with retina1 detachment and vitreous hemorrhage. The visua1 acuity in the 1ast follow-up improved in 36 eyes (85.71% ), and did not improve in 6 eyes (14.29%). The mean visua1 acuity before surgery was (0.15± 0.09), and was increased to (0.31± 0.16) in the last follow-up, the difference was significant (t=5.649, P<0.001). The retina remained attached in 42 eyes. The mean area of macular splitting was (1.07± 0.52)mm2 before the surgery and decreased to (0.22± 0.18)mm2, the difference was significant(t=10. 011, P<0.001). Complications were found in 5 eyes (11.90%), including two eyes with PVR and traction retina1 detachment, two eyes with cataract, and one eye with vitreous hemorrhage. The retina remained attached in these 5 eyes after reoperation.Conclusion:Vitreoretinal surgery can significantly improve visual acuity, resume the anatomic structure of retina, and it presents good clinical efficacy.
Keywords:Congenital retinoschisis  Complication  Vitreoretinal surgery  Treatment outcome
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