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巩膜扣带术是治疗视网膜脱离的常规性手术,但其缺点是填充物可能脱出、侵蚀球壁进入眼内或引起感染,还可导致眼球运动障碍;视网膜下液的眼外引流可并发视网膜下出血、视网膜嵌塞或破裂;此外尚有眼前部缺血、屈光改变等并发症,最终损害视功能。应用玻璃体切除术治疗视网膜脱离,则可避免上述缺点并有以下优点:(1)可直接靠近并切除玻璃体牵引;(2)可作视网膜下液的内引流以避免穿通脉络膜;(3)不须作球外填充;(4)可同时切除混浊的玻璃体;(5)术后反应较巩膜扣带术轻。本文作者报道在睫状体平部作玻璃体切除及气-液置换术治疗29例原发性裂孔性视网膜脱离,随访至少6个月(平均9.6个月)。结果作一次手术视网膜复位者有23眼(79%),未成功者作二次手术使成功
Scleral buckling surgery is a routine treatment of retinal detachment, but its drawback is that the filler may prolapse, erosion of the ball wall into the eye or cause infection, can also lead to eye movement disorders; subretinal fluid extraocular drainage may be complicated by subretinal Bleeding, retinal impaction or rupture; in addition there are anterior eye ischemia, refractive complications such as complications, and ultimately damage visual function. The use of vitrectomy for the treatment of retinal detachment avoids the above disadvantages and has the following advantages: (1) direct traction and removal of the vitreous traction; (2) internal drainage of the subretinal fluid to avoid perforation of the choroid; (3) As filling outside the ball; (4) can be removed at the same time turbid vitreous body; (5) postoperative response than scleral buckling surgery light. The authors report the treatment of 29 cases of primary retinal detachment with pars plana vitrectomy and gas-liquid replacement in the ciliary body for at least 6 months (mean, 9.6 months). Results For a surgical reattachment, there were 23 eyes (79%), those who failed to make a second surgery to succeed