[1]朱磊,李琳,田晓燕,等.巩膜扣带术后影响视网膜复位和视力恢复的相关因素分析[J].眼科新进展,2017,37(2):167-171.[doi:10.13389/j.cnki.rao.2017.0044]
　ZHU Lei,LI Lin,TIAN Xiao-Yan,et al.Correlative factors analysis of affecting anatomical reattachment and vision restoration after scleral buckling surgery[J].Recent Advances in Ophthalmology,2017,37(2):167-171.[doi:10.13389/j.cnki.rao.2017.0044]
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
37卷
期数:
2017年2期
页码:
167-171
栏目:
应用研究
出版日期:
2017-02-05

文章信息/Info

Title:
Correlative factors analysis of affecting anatomical reattachment and vision restoration after scleral buckling surgery
作者:
朱磊; 李琳; 田晓燕; 刘涛; 陈萌; 徐佩; 邹晶; 谢安明
723000　陕西省汉中市，西安交通大学医学院附属三二○一医院眼科（朱磊，田晓燕，刘涛，陈萌，徐佩，邹晶）；723000　陕西省汉中市，汉中市口腔医院正畸科（李琳）；710061陕西省西安市，西安交通大学第一附属医院眼科（谢安明）
Author(s):
ZHU Lei; LI Lin; TIAN Xiao-Yan; LIU Tao; CHEN Meng; XU Pei; ZOU Jing; XIE An-Ming
Department of Ophthalmology，the Affiliated 3201 Hospital of Medical College of Xi’an Jiaotong University（ZHU Lei，TIAN Xiao-Yan，LIU Tao，CHEN Meng，XU Pei，ZOU Jing），Hanzhong 723000，Shaanxi Province，China；Orthodontic Department of Hanzhong Stomatological Hospital（LI Lin），Hanzhong 723000，Shaanxi Province，China；Department of Ophthalmology，the First Affiliated Hospital of Xi’an Jiaotong University（XIE An-Ming），Xi’an 710061，Shaanxi Province，China
关键词:
孔源性视网膜脱离; 巩膜扣带术; 视力恢复; 相关因素
Keywords:
rhegmatogenous retinal detachment; scleral buckling; vision restoration; correlative factors
分类号:
R774.1
DOI:
10.13389/j.cnki.rao.2017.0044
文献标志码:
A
摘要:
目的　分析孔源性视网膜脱离（rhegmatogenous retinal detachment，RRD）行巩膜扣带术后影响视网膜复位和视力恢复的相关因素，为临床治疗提供参考。方法　回顾性临床研究，选择2012年1月至2016年1月我院收治的初发RRD患者行巩膜扣带术治疗者148例148眼，观察术后视网膜解剖复位率、最佳矫正视力（best-corrected visual acuity，BCVA）及并发症，并对可能影响术后视网膜复位和视力恢复的相关因素进行Logistic回归分析。结果　检眼镜和眼底照相检查示首次手术视网膜复位率为91.9%，最终复位率为97.3%；频域光学相干断层扫描（spectral-domain optical coherence tomography，SD-OCT）检查视网膜首次复位率为60.1%，最终复位率为80.4%。单因素Logistic回归分析结果表明：多发视网膜裂孔和C1级增生性玻璃体视网膜病变（proliferative vitreoretinopathy，PVR）对视网膜复位率有显著影响（均为P＜0.05）；单因素Logistic回归分析结果显示：术前BCVA、病程长短、视网膜脱离范围、黄斑累及与否对术后BCVA恢复均有明显影响（均为P＜0.05），而年龄、术前屈光状态、PVR分级、术中是否实施视网膜下放液、玻璃体内注气、联合巩膜外加压、术后视网膜下液对术后BCVA的恢复均无明显影响（均为P＞0.05）；多因素Logistic回归分析结果显示：术前BCVA是影响术后BCVA的独立危险因素（P＜0.05）。结论　巩膜扣带术治疗RRD效果良好，但多发视网膜裂孔和C1级PVR会增加手术失败风险；术前视力、病程长短、视网膜脱离范围、黄斑状态均影响巩膜扣带术后视力的恢复，而术前视力是关键因素，提示RRD患者应早发现、早治疗，尽可能保护术前视力。
Abstract:
Objective　To analyze the effect of treatment of rhegmatogenous retinal detachment(RRD) by scleral bucking as well as the relative risk factors affecting the anatomical reattachment and visual recovery.Methods　One hundred and forty-eight patients (148 eyes) with RRD treated by sclera buckling surgery in our hospital during January 2012 to January 2016 were retrospectively analyzed.The rate of postoperative retinal anatomic reattachment,the best corrected visual acuity (BCVA) and complications were observed.Logistic regression analysis was performed to analyze the correlative factors affecting the anatomical reattachment and postoperative vision restoration.Results　Retinal reattachment achieved in 91.9% after initial surgery and the final success rate for anatomic reattachment was 97.3% assessed with ophthalmoscope and fundus photography.But these two rates were assessed with the optical coherence tomography (OCT) were 60.1% and 80.4% respectively.Single factor Logistic regression analysis showed that retinal detachment was affected by multiple breaks and Grade C1 PVR(all P＜0.05);Single factor Logistic regression analysis showed that preoperative BCVA,course of disease,retinal detachment range,macular involvement or not had an impact on the postoperative recovery of BCVA (all P＜0.05),preoperative age,refractive status,releasing retinal fluid or not,intravitreal gas injection,combined scleral buckling,and postoperative subretinal fluid,all of these factors had no effect on BCVA recovery after surgery (all P＞0.05).And through multiple factors Logistic regression analysis，preoperative BCVA was an independent risk factor for BCVA recovery after surgery (P<0.05).Conclusion　Scleral bucking is an effective technique for managing RRD,but multiple breaks and Grade C1 PVR are significant risk factors for anatomic.Preoperative BCVA,course of disease,retinal detachment range,macular involvement or not have the impact on the BCVA recovery after scleral buckling,and the preoperative BCVA is the key factor.Early diagnosis and early treatment as well as protecting the preoperative visual acuity can improve prognosis.

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更新日期/Last Update: 2017-03-01