摘要
目的研究较复杂的孔源性视网膜脱离患者玻璃体手术或巩膜外手术后的黄斑改变,进一步探讨视网膜脱离术后视功能的恢复。方法回顾性分析孔源性视网膜脱离患者146例152眼手术后的黄斑改变,所有患者术前视力均≥0.1,PVR分级B级,裂孔多、分布广或马蹄形裂孔边缘玻璃体牵引明显的,初次发生的伴黄斑脱离的RRD,随访至少3个月。152眼中行巩膜外手术90眼为A组,行玻璃体手术62眼为B组。结果A、B二组术后视力均显著提高(P<0.01),组间无显著性差异(P>0.05)。黄斑形态学改变中,A组表面膜发生率20.0%,较B组8.0%有显著差异(P<0.05),色素紊乱、水肿、渗出、视网膜下膜发生率组间均无显著性差异(P>0.054)。视觉不适中B组视物变形、眼前闪光、眼球疼痛三个指标明显低于A组(P<0.05),小视、色视、复视三个指标稍低于A组(P>0.05)。结论玻璃体手术对黄斑部的影响较小,视觉不适明显改善,对术后视功能的恢复更有利,但易并发白内障。
Objective To study the relationship between the macular abnormities and visual acuity after scleral buckling versus primary vitrectomy in macular-off rhegmatogenous retinal detachment(RRD).Methods 146 cases (152 eyes) of macular-off RRD were retrospectively reviewed,the visual acuity of all the cases was better than 0.1,and PVR grade was B.90 eyes which were operated with scleral buckling were assigned to group A,and 62 eyes with vitrectomy were assigned to group B.Results The visual acuity after operation was increased prominently both in group A and B(P<0.01),and there was no difference between A and B(P>0.05).The occur rate of macular epithelial membrane in group A(20.0%) was higher than group B (8.0%) (P<0.05).There were no difference among macular pigment disorder?edema?exudation and subretinal membrane between group A and B(P>0.05).Three indexes of visual distortion?flash feeling?eyeball ache in group B were lower than group A(P<0.05).The vision disorders of microvision?color vision?diplopia were fewer in group B than A(P>0.05).Conclusions Vitrectomy caused fewer macular abnormities and vision disorders than scleral buckling,which was good for visual recover.
出处
《中国实用眼科杂志》
CSCD
北大核心
2005年第5期496-498,共3页
Chinese Journal of Practical Ophthalmology
