[1]魏莹莹,王志玲,邹皋城,等.术前双眼遮盖及体位控制对孔源性视网膜脱离患者视网膜下积液吸收的作用[J].眼科新进展,2019,39(1):049-52.[doi:10.13389/j.cnki.rao.2019.0011]
　WEI Ying-Ying,WANG Zhi-Ling,ZOU Gao-Cheng,et al.Effect of preoperative binocular patching and head positioning on subretinal fluid absorption in patients with rhegmatogenous retinal detachment[J].Recent Advances in Ophthalmology,2019,39(1):049-52.[doi:10.13389/j.cnki.rao.2019.0011]
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术前双眼遮盖及体位控制对孔源性视网膜脱离患者视网膜下积液吸收的作用/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年1期
页码:
049-52
栏目:
应用研究
出版日期:
2019-01-05

文章信息/Info

Title:
Effect of preoperative binocular patching and head positioning on subretinal fluid absorption in patients with rhegmatogenous retinal detachment
作者:
魏莹莹; 王志玲; 邹皋城; 周恩亮; 柯根杰; 顾永昊
230001　安徽省合肥市，安徽医科大学附属安徽省立医院眼科
Author(s):
WEI Ying-Ying; WANG Zhi-Ling; ZOU Gao-Cheng; ZHOU En-Liang; KE Gen-Jie; GU Yong-Hao
Department of Ophthalmology，Anhui Provincial Hospital Affiliated to Anhui Medical University，Hefei 230001，Anhui Province，China
关键词:
双眼遮盖; 体位控制; 孔源性视网膜脱离; 视网膜下积液
Keywords:
binocular patch; head positioning; rhegmatogenous retinal detachment; subretinal fluid
分类号:
R774.1
DOI:
10.13389/j.cnki.rao.2019.0011
文献标志码:
A
摘要:
目的　探讨孔源性视网膜脱离患者术前双眼遮盖对减少视网膜下积液和手术效果的影响。方法　收集2017年4月至12月在安徽医科大学附属省立医院确诊为孔源性视网膜脱离并手术患者197例197眼，随机分为试验组100例100眼、对照组97例97眼，试验组术前给予患者约12 h双眼遮盖并使裂孔保持最低位，对照组未做特殊处理，记录患者年龄、性别、病程、裂孔情况、增生性玻璃体视网膜病变（proliferative vitreoretinopathy，PVR）分级、视网膜脱离等。综合直接眼底镜、间接眼底镜以及B超定量方法综合判断视网膜下积液情况。根据手术适应证，手术方式分为巩膜扣带术和玻璃体切割术，记录每例患者手术方式、时间和术中情况，并随访术后视网膜复位时间及术后视力恢复情况。结果　对照组有4例4眼视网膜下积液减少，试验组有38例38眼视网膜下积液减少，两组比较差异有统计学意义（P<0.05）。试验组行巩膜扣带术患者中视网膜下积液减少（27例27眼）与视网膜下积液未减少（31例31眼）者在术中操作、手术时间、术后视力方面差异均有统计学意义（均为P<0.05）；试验组行玻璃体切割术患者中视网膜下积液减少者（11例11眼）与视网膜下积液未减少者（31例31眼）在手术时间及术后视力等方面差异均无统计学意义（均为P>0.05）。试验组视网膜下积液减少与未减少者之间在PVR分级和年龄方面差异均有统计学意义（均为P<0.05），Logistic回归分析显示年龄较小和PVC分级较轻是促进视网膜下积液吸收的独立因素（均为P<0.05）。结论　术前双眼遮盖及保持体位控制能够有效减少视网膜下积液，对于PVR较轻的年轻患者更为有效。对于行巩膜扣带术患者能够使手术时间缩短，减少术中操作，患者术后视力恢复也较佳。
Abstract:
Objective　To investigate the effect of binocular patching on subretinal fluid absorption and surgical outcome in patients with rhegmatogenous retinal detachment.Methods　From April 2017 to December 2017，totally 197 consecutive patients （197 eyes） with rhegmatogenous retinal detachment at Anhui Provincial Hospital Affiliated to Anhui Medical University were enrolled in the study.They were randomly divided into 100 patients （100 eyes） in the experimental group and 97 patients （97 eyes） in the control group.Patients in the experimental group were preoperative bilateral patched and heads were positioned in a manner，with the retinal tears at the lowest point of the globe for 12-hour（12 h）while individuals in the control group left untreated.The age and gender of the patients，duration of disease，number and position of the tears/holes，proliferative vitreoretinopathy （PVR） classification were recorded.The height and extent of retinal detachment were observed by direct and indirect binocular ophthalmoscopy and quantitative B-scan ultrasound.Surgical methods were assigned into scleral buckling and vitrectomy based on surgical indications.The surgical method，duration and intraoperative status of each patient were collected，after which their postoperative retinal reattachment and visual acuity recovery were followed up for 3 months.Results　Compared with 38 eyes in the experimental group，there were only 4 eyes in the control group with subretinal fluid absorption.There was a significant difference in the reduction of subretinal fluid between two groups （P<0.05）.Individuals，undergoing scleral buckling in the experimental group，were consisted of 27 eyes with subretinal fluid absorption and 31 eyes with no obvious change，and the two groups were significantly different in operation time，postoperative visual acuity（all P<0.05）.Patients，undergoing vitrectomy in the experimental group，were composed of 11 eyes with subretinal fluid absorption and 31 eyes without resulted alteration，there was no significant difference between the two groups in both operation time and postoperative visual acuity（all P>0.05）. However，it appeared to be a significant difference in the experimental group between patients experienced a subretinal fluid resorption and individuals without validated resorption for the PVR grade and the age （both P<0.05）.Logistic regression analysis showed that younger age and lighter PVR classification were independent factors in promoting subretinal fluid absorption （both P<0.05）.Conclusion　Preoperative binocular patching and specific head positioning can markedly decrease the subretinal fluid especially for young patients with mild PVR grade.For patients who undergo scleral buckling，it did not only shorten the operation time but also reduce the operation chance of subretinal fluid discharge.Apart from that，it can improve the postoperative visual acuity.

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备注/Memo

备注/Memo:
安徽省自然科学基金项目（编号：1508085SMH230）
更新日期/Last Update: 2019-01-04