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显微镜直视下外路手术治疗裂孔源性视网膜脱离的临床研究
作者:陈星  文章来源:成都普瑞眼科医院  点击数271  更新时间:2011/9/13  文章录入:毛进  责任编辑:毛进
目的 研究探讨显微镜直视下外路手术治疗裂孔源性视网膜脱离的临床疗效。
方法 对增殖性视网膜病变在c 以下的裂孔源性视网膜脱离患者32例32眼,术前用三面镜详细检查裂孔及变性区的形态、跨度,并记录裂孔前、后界距角膜缘后的距离、方向,以指导术中硅胶垫压、放液的具体位置。常规预置巩膜板层缝线,显微镜直视下放液后,冷凝器顶压巩膜更精确地查找、定位视网膜裂孔、变性区并冷凝封闭。最后完成巩膜外垫压或环扎。术后观察视力、视网膜复位、并发症情况,并随访3-12月。
结果 30例患者达到视网膜脱离的解剖复位,1例患者术后出现其他部位的新裂孔,1例患者手术中未完全封闭所有裂孔,1例巩膜穿透,6例术后角膜水肿。术后冷凝区视网膜均无过度炎性及冷凝反应。
结论 显微镜直视下外路手术治疗增殖性视网膜病变在c 以下的裂孔源性视网膜脱离安全、精确、疗效可靠,具有很高临床应用价值。
AIM :To find the surgical treatment of rhegmatogenous retinal detachment under microscope
METHODS:Of proliferative retinopathy in the c following rhegmatogenous retinal detachment in 32 eyes of 32 patients, preoperative detailed inspection mirror with three holes and denatured form area, span, and record the hole before and after the community's distance from the limbus, Direction to guide the operation pressure in the silicone mat and put the specific location of liquid. Conventional pre-lamellar scleral sutures, microscopes look decentralized solution, the condenser top pressure to find a more accurate sclera, location of retinal holes and degeneration area and condensation closed. Scleral buckling finalized or cerclage. Postoperative visual acuity, retinal reattachment, complications, and follow-up 3-10months.
RESULTS:30 cases of retinal detachment patients achieved anatomical reduction, 1 patient after the operation of other parts of the new hole, and 1 patient surgery is not completely closed all the holes, and 1 scleral penetration, 6 cases of corneal edema. There was no excessive postoperative inflammatory retinal condenser and condensation reactions.
CONCLUSlON:Under the microscope, look outside the surgical treatment of proliferative retinopathy in the c following rhegmatogenous retinal detachment safe, accurate, effective and reliable, with high clinical value.
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