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目的观察视网膜脱离(retinaldetachment,RD)以及巩膜扣带术(scleralbucking,SB)对视网膜和视乳头血流的影响。方法52例52眼单眼RD接受常规SB,手术方式包括巩膜环扎术、巩膜外冷冻术、眼内注气,应用共焦扫描激光多普勒视网膜血流分析仪(Heidelbergretinalflowmeter,HRF)检测术前患眼和对侧健眼的视网膜和视乳头血流灌注情况。术后随访3m。结果RD组眼底血流检测参数普遍低于健眼,SB后视乳头大血管的血流量、血流速术后各组低于健眼及术前组,颞侧视乳头盘沿的血流量、血流速术后各组低于健眼,鼻侧视乳头盘沿的血流量术后各组低于健眼(P<0.05)。结论RD眼眼底血流明显下降,其对视乳头和视网膜的血流量影响最大,在对眼底各部位影响方面,以对视乳头大血管三项指标的影响最大。而术后视网膜复位并没有改善其眼底血流,这可能是RD术后视功能的恢复不理想的一个重要原因。
Objective To observe the effects of retinal detachment (RD) and scleral buckling (SB) on the blood flow of retina and optic disc. Methods Fifty-two eyes (52 eyes) of monocular RD underwent routine SB. The surgical methods included scleral cerclage surgery, extra-scleral cryosurgery and intraocular gas injection. Heidelberg’s retinal flowmeter (HRF) Eye and contralateral eye retinal and optic nerve blood perfusion. Follow-up 3m. Results The blood flow parameters in RD group were generally lower than those in healthy eyes and SB papillae. The blood flow in each group was lower than that in healthy eyes and preoperative group, Blood flow was lower in each group than the healthy eye, nasal optic disc rim along the blood flow was lower than healthy eye group (P <0.05). Conclusion The blood flow of RD eyes is obviously decreased, which has the greatest influence on the blood flow of the optic disc and the retina. In terms of the influence on various parts of the fundus, it has the greatest influence on the three indexes of the great vessels of the optic nerve. Postoperative retinal reattachment did not improve the retinal blood flow, which may be an important reason for the poor recovery of visual function after RD surgery.