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目的:探讨视网膜切开及切除治疗复杂性视网膜脱离的手术疗效、方法、适应证、并发症及处理原则。方法:在初步进行视网膜切开及切除术治疗复杂性视网膜脱离的基础上,1994年1月至1996年6月,对36例(36眼)复杂性视网膜脱离患者,行巩膜扣带、玻璃体切除、膜剥离、视网膜切开及切除、眼内填充,部分病例术后补充激光治疗,术后随访3至12月,观察患者视网膜复位、视功能恢复的情况及手术中、手术后的并发症。结果:术中32眼视网膜复位,4眼放弃治疗。术中成功的32眼中,8眼视网膜脱离复发,4眼接受再次手术,3眼视网膜复位。最终解剖成功27眼,成功率75.0％。术前视力33眼指数以下,3眼0.05以下,术后0.05以上视力20眼(55.5％)。术中术后并发症有视网膜切口出血,视网膜切开口扩大,硅油、过氟葵烷进入视网膜下,硅油乳化,并发性白内障,低眼压等。结论:视网膜切开对复杂性视网膜脱离的治疗有一定帮助,但有较严重并发症,应严格掌握手术适应症。眼科学报1998;14:94—96。
Objective: To investigate the curative effect, methods, indications, complications and treatment principles of retinal detachment and resection for complicated retinal detachment. Methods: From January 1994 to June 1996, 36 patients (36 eyes) with complicated retinal detachment underwent scleral buckling and vitrectomy on the basis of preliminary retinal detachment and resection for complicated retinal detachment , Retinal detachment and resection, intraocular filling, some cases of postoperative laser treatment, follow-up 3 to 12 months after surgery to observe the patient’s retina, visual function recovery and surgery, postoperative complications. Results: Intraoperative retina was repositioned in 32 eyes and 4 eyes gave up treatment. Of the 32 eyes successfully treated, 8 had retinal detachment recurrence, 4 received reoperation and 3 had retinal reattachment. The final success of anatomy in 27 eyes, the success rate of 75.0%. Preoperative visual acuity less than 33 eyes, 3 eyes less than 0.05, postoperative visual acuity of more than 0.05 (55.5%). Intraoperative complications of retinal incision bleeding, retinal incision to expand, silicone oil, perfuracil into the retina, silicone oil emulsification, complicated cataracts, low intraocular pressure and so on. Conclusion: Retinal incision may be helpful to the treatment of complex retinal detachment, but there are more serious complications. Operation indications should be strictly controlled. Ophthalmic Science 1998; 14: 94-96.