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目的观察玻璃体视网膜手术治疗晚期大泡状视网膜脱离的疗效。方法回顾分析经裂隙灯显微镜、三面镜及间接检眼镜、B型超声以及荧光素眼底血管造影检查确诊,无法进行有效激光光凝而行玻璃体视网膜手术治疗的晚期大泡状视网膜脱离患者7例9只眼的临床资料。所有患眼均在局部麻醉下巩膜穿刺放出视网膜下液后,行睫状体扁平部的闭合式三切口玻璃体切割手术。去除玻璃体及后皮质,视网膜内引流,吸出视网膜下液体,激光光凝封闭视网膜切开处和渗出区,气液交换后注入眼内填充物。手术后随访3个月~8年,平均随访时间47个月。结果随访期内视网膜均复位。1只眼在手术后2年复查时因视网膜前增生膜牵引形成一裂孔,并有一硅油泡进入视网膜下造成局部视网膜脱离而行第二次手术治疗,手术后随访1年视网膜平复。8只眼手术后视力较手术前有不同程度提高,1只眼手术后视力无改变。结论晚期严重大泡状视网膜脱离患者行玻璃体视网膜手术治疗能安全有效地促进视网膜复位,挽救患眼的部分视力。
Objective To observe the effect of vitreoretinal surgery for the treatment of advanced vesicular retinal detachment. Methods Retrospective analysis of 7 patients with advanced vesicular retinal detachment who underwent vitreoretinal surgery who were diagnosed by slit lamp microscope, three-mirror and indirect ophthalmoscope, B-mode ultrasound and fluorescein fundus angiography was unable to perform effective laser photocoagulation. Eye of the clinical data. All eyes were under partial anesthesia scleral puncture release subretinal fluid, the ciliary body flattened closed triple incision vitrectomy. Removal of vitreous and posterior cortex, retinal drainage, sucked out of the subretinal fluid, laser photocoagulation closed retinal incision and exudative area, after the exchange of gas and liquid into the eye filler. The patients were followed up for 3 months to 8 years and the average follow-up time was 47 months. Results The retina was reset during the follow-up period. One eye was retrospectively 2 years after surgery because of retinal preadrenal traction to form a hole, and a silicone oil bubble into the retina caused by partial retinal detachment line second surgery, retinal recovery after 1-year follow-up. The visual acuity of the 8 eyes after operation was improved to some extent compared with that before operation, and the visual acuity of one eye did not change after operation. Conclusion The treatment of vitreoretinal surgery in patients with advanced severe vesicle retinal detachment can safely and effectively promote retinal reattachment and save part of eyesight.