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复杂的视网膜脱离除了必需封闭裂孔外,尚需加用各种巩膜手术,而用各种材料环绕眼球一周的环扎术,即是其中之一,以往我们多采用保存巩膜、羊膜作环扎术,近年改用双线环扎治疗复杂的视网膜脱离18例,疗效较好,特介绍如下。(一)手术方法: 1、术前准备同一般视网膜脱离手术。2、常规消毒,铺枕、洞巾,球后与结膜下麻醉。3、置开睑器,距角膜缘约5毫米处环形剪开球结膜,根据需要切断1～2条直肌或不切断直肌,暴露手术区巩膜,以虹膜簏或光导管定位裂孔,以冷凝或电凝封闭裂孔,如未找到明显裂孔,可在锯齿缘与赤道部之间作两排360度的电凝或冷凝。但需注意勿使过量。4、在眼球一周放置双根巩膜缝线:对未找到明显裂孔者,在距角膜缘约9毫米之颞上、颞下、鼻下及鼻上4个象限的浅层巩膜上,依次穿过一根0号黑丝线
Complex retinal detachment in addition to the need to close the hole, the need to add a variety of scleral surgery, and a variety of materials around the eye cerclage, which is one of the past, we use the preservation of the sclera, amniotic membrane for cerclage In recent years, the use of double cerclage treatment of complex retinal detachment in 18 cases, the effect is better, special introduction is as follows. (A) surgical methods: 1, preoperative preparation with the general retinal detachment surgery. 2, conventional disinfection, shop pillow, towel, ball and conjunctival anesthesia. 3, open the eyelid device, from the corneal edge of the ring about 5 mm cut the bulb conjunctiva, according to the need to cut off 1 or 2 rectus muscles or do not cut off the rectus muscle, exposed surgical sclera, iris or light pipe to locate the hole to Condensation or electrocoagulation closed the hole, if no obvious cracked hole, between the serrated edge and the equator can be two rows of 360 degrees of coagulation or condensation. But be careful not to overdose. 4, in the eye a week to place double root scleral suture: For those who did not find a clear hole, about 9 mm from the limbus on the temporal, temporal, nasal and nasal four quadrants of the superficial sclera, followed by A 0 black thread