摘要
目的报告一组高度近视眼由黄斑裂孔引起的原发性视网膜脱离经玻璃体手术治疗的结果。方法回顾性分析自1996年3月至2004年3月连续进行的一组病例，纳入标准为原有屈光不正≥-6．00D，或眼轴≥26mm，未发现周边视网膜裂孔，且经玻璃体手术治疗、由黄斑裂孔引起的原发性视网膜脱离。结果本组患者83例，其中女63例，男20例，85只眼，平均年龄54．1岁。手术前视力光感-数指49只眼，0．01～0．1者33只眼，0．12～0．2者3只眼。视网膜脱离范围仅限于黄斑部15只眼，1～2个象限11只眼，3～4个象限59只眼。手术中同时做晶状体切除或超声粉碎62只眼（72．9％），黄斑前膜切除37只眼，注入C3；F829只眼（34.1％），注入硅油56只眼（65．9％）。手术后视网膜复位77只眼（90．6％），末复位8只眼。手术后视力改善47只眼（55．3％），不变25只眼（29．4％），下降13只眼（15.3％）。结论由于黄斑裂孔引起的原发性视网膜脱离多发生在年龄较大、女性高度近视跟，玻璃体手术具有同时进行玻璃体后皮质和黄斑前膜切除、品状体摘除和眼内填充的优势，手术后大多数眼能改善或保持视力。
Objective To investigate the therapeutic effects of vitrectomy for primary retinal detachment due to macular hole in high myopic eyes. Methods Consecutive patients with primary retinal detachment due to macular hole who went to our hospital from March 1996 to March 2004 were retrospectively analyzed. The condition of the patients must accord with the previous refractive error of -6.00 D or the axial length of ≥ 26 mm without peripheral retinal hole; and with primary retinal detachment due to macular hole which had undergone vitrectomy. Results In 83 patients （85 eyes） including 63 females and 20 males with an average age＇of 54. 1 years, pre-operative visual acuity was light perception to counting finger in 49 eyes, 0.01-0. 1 in 33, and 0. 12-0.2 in 3 eyes; the extent of retinal detachment was only in the macular area in 15 eyes, in 1-2 quadrants in 11 eyes, and in 3-4 quadrants in 59 eyes ; extraction of the lens or phako-fragmentation was simultaneously performed during the operation in 62 eyes （72.9%）, macular epiretinal membrane was removed in 37 eyes, and C3F8 or silicone oil was injected intravitreously in 29 （34.1%） and 56 （65.9%） eyes, respectively; the retina was reattached postoperatively in 77 eyes （90.6%） and failed to reattach in 8; visual acuity improved in 47 eyes （55.3%）, remained unchanged in 25 （29.4%）, and decreased in 13 （15.3%） after operation. Conclusions Primary retinal detachment due to macular hole often occurs in elder female patients with high myopic eyes. Simultaneous vitrectomy procedures including removal of posterior vitreous cortex, macular epiretinal membrane, cataractous lens and internal tamponade may usually beneficial to improve or preserve. The visual acuity improves or remains still in most of the affected eyes after the surgery.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2006年第5期287-290,共4页
Chinese Journal of Ocular Fundus Diseases
