单纯巩膜扣带术治疗硅油填充视网膜脱离的护理

现代玻璃体手术联合眼内硅油填充术在治疗复杂性视网膜脱离病例中取得良好的效果,但临床中有相当一部分病例硅油填充术后仍有部分视网膜脱离,特别是下方视网膜[1-4]脱离.我院于2000年-2003年采用单纯巩膜扣带术治疗硅油填充眼视网膜脱离31例,辅以精心治疗和护理,取得满意效果.现将护理报告如下.

Purpose: To evaluate the efficacy of a new technique to repair retinal detachments (RD) under the microscope. Methods: Thirty-six consecutive patients (36 eyes) who presented to our clinic with rhegmatogenous RD without severe proliferative vitreoretinopathy (≤ C1) were included. The sutures for buckling and/or encircling bands were preplaced according to the preoperative location of the breaks using a three-mirror contact lens. Drainage of subretinal fluid, retinal cryotherapy, buckling, locating the retinal breaks, and intravitreal gases injection were performed under surgical microscopy. The surgical effects were compared with those in 37 consecutive patients with rhegmatogenous RD who underwent surgery under binocular indirect ophthalmoscopy.Results: The simultaneous intraoperative observation of fundus details and the sclera through the microscope was excellent in all cases. The effect of retinal cryotherapy was clearly visible. Mild opacity of the refractive media did not interfere with observing cryotherapy and locating the breaks. Retinal reattachment was obtained in31 eyes (86%) during the primary surgery and in three eyes after a second surgery(94% total). The best-corrected visual acuity was ＜0.1 in 6 eyes (16.7%), 0.1～0.4 in 15 eyes (41.7%) and ≥ 0.5 in 15 eyes (41.7%). The results were similar to that of RD surgery performed under indirect ophthalmoscopy.Conclusions: This microsurgical procedure to correct RD is simple, convenient,reliable, provides an upright image, and facilitates good recovery similar to conventional RD surgery.