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目的探讨视网膜脱离患者对侧眼的变性和裂孔情况和氩(Ar)激光对视网膜脱离术后裂孔的加固作用及对视网膜裂孔、格样变性的治疗效果。方法对2000年7月至2004年7月因视网膜脱离在我院行巩膜外加压或玻璃体切割术的患者,常规对对侧眼行散瞳三面镜眼底检查,对视网膜格样变性及裂孔进行登记并行Ar激光封闭。术眼在术后4d至1个月行三面镜眼底检查,对裂孔边缘仍清晰者行Ar激光封闭裂孔边缘及周边视网膜共4～5排。追踪观察至少3个月。结果251例视网膜脱离患者中,行外加压手术175例,行玻璃体切割手术76例,其中术后行裂孔Ar激光光凝的有60例。251例患者对侧眼检查中,64例有单纯视网膜格样变性,74例有视网膜格样变性及视网膜裂孔,其中53例为圆形萎缩状裂孔,21例为马蹄性裂孔。48例为单个裂孔,26例为多个裂孔。其中13例合并视网膜脱离。除3例对侧眼合并明显视网膜脱离者行手术治疗外,其他135例均行Ar激光封闭。追踪观察3个月至3年,3例患者出现新裂孔,其中1例为多发性马蹄状裂孔。均经Ar激光再次封闭成功。结论视网膜脱离患者对侧眼出现视网膜格样变性及视网膜裂孔的几率高,仔细散瞳检查应作为常规。Ar激光封闭作为加固性和预防性光凝成功率高,效果好;但仍有必要进行随访,以防新裂孔的发生。
Objective To investigate the degeneration and hiatus of the contralateral eye in patients with retinal detachment and the reinforcing effect of argon (Ar) laser on hiatus after retinal detachment and the therapeutic effect on retinal breaks and degeneration. Methods From July 2000 to July 2004 due to retinal detachment in our hospital under scleral buckling or vitrectomy, routine ophthalmoscopy on the contralateral eye dilation fundus examination of retinal degeneration and hiatus Registration parallel Ar laser sealing. Eye surgery in the postoperative 4d to 1 month trip three-eye fundus examination, the edge of the hole is still clear and the Ar laser closed the edge of the hole and the surrounding retina a total of 4 to 5 rows. Follow up for at least 3 months. Results Among 251 patients with retinal detachment, 175 cases underwent extracorporeal pressure surgery and 76 cases underwent vitrectomy. Among them, 60 cases were treated with open-hole Ar laser photocoagulation. Of the 251 patients who underwent contralateral eye examinations, 64 had simple retinal degeneration, 74 had retinal degeneration and retinal tears, of which 53 were round atrophic and 21 were horseshoe-shaped. 48 cases of a single hole, 26 cases of multiple holes. Thirteen of them had retinal detachment. Except 3 cases of contralateral eye with obvious retinal detachment underwent surgical treatment, the other 135 cases were performed Ar laser occlusion. Three months to three years follow-up observation. Three patients developed a neoplasm, of which one case had multiple horseshide-shaped holes. After Ar laser closed again successfully. Conclusion Retinal detachment in patients with retinal degeneration and retinal degeneration of the high risk of retinal breaks, careful mydriatic examination should be routine. Ar laser closure as a curable and prophylactic photocoagulation success rate, good effect; but there is still a need for follow-up to prevent the occurrence of new hiatus.