广西医学2018，Vol.40Issue(3)：249-252,4.DOI:10.11675/j.issn.0253-4304.2018.03.03
23G玻璃体切割术联合巩膜扣带术在眼球内异物伴视网膜脱离中的临床疗效
Clinical efficacy of 23G pars plana vitrectomy combined with scleral buckle for removal of intraocular foreign bodies companied by retinal detachment
摘要
Abstract
Objective To evaluate the clinical efficacy of 23 gauge pars plana vitrectomy(PPV) combined with scleral buckle (SB) for removal of intraocular foreign bodies(IOFB) companied by retinal detachment(RD).Methods The clinical data of 42 patients (42 eyes) with IOFB companied by RD were retrospectively analyzed.The patients were divided into observation group(n=21) and control group(n=21) according to the surgical approaches.Patients in the observation group received 23 gauge PPV,SB,IOFB removal,silicone oil tamponade,and endolaser photocoagulation and/or transscleral cryotherapy.Patients in the control group underwent 23 gauge PPV,IOFB removal,silicone oil tamponade,and endolaser photocoagulation and/or transscleral cryotherapy.Intraocular silicone oil was removed after three to six months of operation.The postoperative visual acuity,intraocular pressure,anatomical reduction rate and incidence of complications were compared between the two groups.Results All of IOFBs were removed successfully in the 42 cases.After three months of silicone oil removal,the best corrected visual acuity was improved in the two groups compared to the preoperative(P＜0.05),and no statistically significant difference was found between the two groups(P＞0.05).The intraocular pressure showed no statistically significant difference between the two groups at various time points(P＞0.05);the intraocular pressure on the first day or in the first week after PPV was higher than the preoperative in both groups(P＜0.05),compared to the preoperative,the intraocular pressure did not present significant changes in the observation group(P＞0.05) but was lower in the control group(P＜0.05) after three months of silicone oil removal.After PPV,21 cases achieved a success anatomical reduction in the observation group,and 20 in the control group.After silicone oil removal,RD recurrence was observed in two cases(9.52%) of the observation group and seven cases(35.00%) of the control group;and the final success rate of anatomical reduction in the observation group was higher than that in the control group[90.48%(19/21) vs. 61.90%(13/21);P＜0.05].There was no significant difference in the incidence rate of temporary high intraocular pressure within one week after operation between the two groups(P＞0.05).The incidence rate of cataract was 100% in both groups.Two cases(9.52%) of silicone oil emulsification and one case(4.76%) of lower intraocular pressure occurred in each group.Conclusion PPV combined with SB is a safe and effective approach, with a higher success rate of anatomical reduction,for the treatment of IOFB complicated with RD.关键词
眼球内异物/视网膜脱离/玻璃体切割术/巩膜扣带术Key words
Intraocular foreign body/Retinal detachment/Pars plana vitrectomy/Scleral buckle分类
医药卫生引用本文复制引用
孙好良,刘金华,黄敏丽..23G玻璃体切割术联合巩膜扣带术在眼球内异物伴视网膜脱离中的临床疗效[J].广西医学,2018,40(3):249-252,4.基金项目
广西自然科学基金(2014GXNSFAA118273) （2014GXNSFAA118273）
