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治疗黄斑裂孔性视网膜脱离有很多手术方法,包括黄斑裂孔凝固和黄斑扣带,也有以赤道部巩膜切除代替黄斑扣带。这些方法的主要缺点是:(1)手术复杂,(2)凝固使黄斑区永久破坏伴功能丧失,(3)并发症较多。黄斑裂孔通常使中心视力下降到20/100～20/200,有视网膜脱离黄斑裂孔的凝固使视力进一步下降至20/200以下。为避免这种医源性的视力丧失,Cockerhain等建议在放液和吸出玻璃体后,眼内注入硅油,以便从内部封闭黄斑裂孔。遗憾的是,硅胶对眼内引起的近期和远期的并发症提出较多的争论。作者用玻璃体切割术、部分气体-液体交换和俯卧位治疗6例有黄斑裂孔的视网膜脱离。5例原发性裂孔,年龄47—70岁,近视-7.75～19.0 DS,1例外伤性视网膜脱离,22岁,正视。5例视网膜脱离扩展到赤道部,有时呈球形脱离,2例在后极部呈明显的近视性葡萄肿。脱离出现与诊断之间的时间估计为2天～2年。手术方法:以备有光导纤维的玻璃体注吸切
Treatment of macular hole retinal detachment There are many surgical methods, including macular hole coagulation and macular buckling, scleral replacement of the equator but also to replace the yellow cingulate. The main drawbacks of these methods are: (1) complex surgery, (2) coagulation to permanently destroy macular degeneration and loss of function, and (3) more complications. Macular hole usually makes the central vision decreased to 20/100 ~ 20/200, with retinal detachment of macular hole coagulation further reduce vision to 20/200 or less. To avoid this iatrogenic loss of vision, Cockerhain et al suggest that silicone oil be injected intraocularly after draining and aspirating the vitreous to occlude the macular hole from the inside. Unfortunately, silica gel has raised more controversy over the near-term and long-term complications caused by the eye. The authors used vitrectomy, partial gas-liquid exchange, and prone position to treat retinal detachment in 6 patients with macular holes. 5 cases of primary holes, aged 47-70 years, myopia -7.75 ~ 19.0 DS, 1 case of traumatic retinal detachment, 22 years old, face. 5 cases of retinal detachment extended to the equator, sometimes spherical detachment, 2 cases showed obvious myopia in the posterior pole of the staphyloma. The time between emergence and diagnosis is estimated to be 2 days to 2 years. Surgical methods: prepared with optical fiber glass injection suction cut