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目的观察巩膜外垫压术治疗直肌下裂孔引发的视网膜脱离的疗效,探讨其临床特点。设计回顾性病例系列。研究对象西京医院47例(47眼)裂孔位于直肌下的视网膜脱离患者。方法所有患者均行巩膜外垫压术治疗,术中采用硅胶海绵或硅胶轮胎在相应位垫压(或联合环扎),使裂孔位于垫压嵴上;部分病例联合消毒空气玻璃体内注入术。主要指标治疗前后视力变化、视网膜复位状况。结果手术后随访6个月～1年(平均7.3个月),一次手术后视网膜完全复位率为89.4%(42∕47眼),好转率93.6%(44∕47眼);视力提高率为80.9%(38∕47眼)。未见复视及眼球运动障碍等相关并发症。结论裂孔位于直肌下的视网膜脱离行巩膜外垫压(或联合环扎)术时有其特殊性,选择适当垫压材料、注重手术技巧以及精心操作,可获得较高的手术成功率,并可避免相关并发症的发生。
Objective To observe the effect of scleral buckling in the treatment of retinal detachment caused by rectus abdominis and discuss the clinical features. Design retrospective case series. The study included 47 cases (47 eyes) of Xijing Hospital with retinal detachment under the rectus muscle. Methods All patients underwent scleral buckling, with intraoperative silicone sponge or silicone rubber tires in the corresponding position padding (or combined with cerclage), so that the hole is located in the pad crest ridge; some cases combined disinfection of air glass intravitreal injection. The main indicators of visual acuity before and after treatment, retinal reattachment. Results The patients were followed up for 6 months to 1 year (mean 7.3 months). The rate of complete reattachment was 89.4% (42/47 eyes) and the improvement rate was 93.6% (44/47 eyes) after one operation. The rate of improvement of vision was 80.9 % (38/47 eyes). No diplopia and eye movement disorders and other related complications. Conclusion The retinal detachment under the rectus abdominis posterior sclera extracapsular pressure (or combined cerclage) has its own particularity, choose the appropriate padding materials, pay attention to surgical techniques and meticulous operation, to obtain a higher success rate of surgery, and To avoid the occurrence of complications.