微创玻璃体手术治疗儿童青少年特殊孔源性视网膜脱离的临床疗效观察

Q4 Medicine

中华眼底病杂志 Pub Date : 2019-11-25 DOI:10.3760/CMA.J.ISSN.1005-1015.2019.06.008

Chao-wei Tian, Jing Wu, Yusheng Wang

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引用次数: 0

摘要

目的观察微创玻璃体手术治疗儿童青少年特殊孔源性视网膜脱离(RRD)的临床疗效。方法回顾性临床比较研究。选取2014年1月至2019年1月在空军军医大学第一附属医院眼科接受MIVS治疗的14例儿童青少年14只特殊类型RRD的眼睛作为研究对象。其中男性8只眼，女性6只眼。年龄5 ~ 17岁，平均12.64±4.11岁。病程1 d ~ 1年，平均30 d。所有眼均发生特殊类型RRD，包括假性晶状体视网膜脱离、无晶状体视网膜脱离、巨大视网膜撕裂合并视网膜脱离、脉络膜脱离合并视网膜脱离、RRD合并眼发育不良。14只眼中，1象限2眼视网膜脱离，2象限4眼，3象限1眼，共4象限7眼。所有眼分别用23G或25G MIVS处理，灌洗液、空气和硅油填充。术后平均随访10.4个月，观察眼底视网膜再植、BCVA及相关并发症的发生情况。结果14只眼中，13只眼(92.9%)获得视网膜再植，1只眼(7.1%)视网膜再植不良。末次随访14只眼(100.0%)视网膜再植，其中5只眼处于硅油填充状态。视力改善8眼(57.1%)，无明显变化4眼(28.6%)，视力下降2眼(14.3%)。术中1眼发生医源性视网膜断裂，1眼有硅油进入视网膜下。术后1眼取出硅油后视网膜脱离复发，再次填充。结论MIVS是一种安全有效的治疗儿童青少年特殊类型RRD的方法。术后视网膜复植率为92.9%，末次随访为100.0%。因此，MIVS可以帮助大多数特殊类型RRD的眼睛获得稳定和改善的视力。关键词:视网膜脱离/手术;手术适应症;孩子;青少年

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Clinical efficacy of minimally invasive vitreous surgery for special rhegmatogenous retinal detachment in children and adolescents

Objective To observe the clinical efficacy of minimally invasive vitreous surgery (MIVS) for special rhegmatogenous retinal detachment (RRD) in children and adolescents. Methods A retrospective clinical comparative study. Fourteen eyes with special type of RRD in 14 children and adolescents who received the MIVS treatment from January 2014 to January 2019 in Ophthalmology Department of The First Affiliated Hospital Ophthalmology of Air Force Military Medical University, were included in this study. Among them, 8 eyes from 8 males and 6 eyes from 6 females. The age of them ranged from 5 to 17, with the mean age of 12.64±4.11 years. The course of disease was ranged from 1 d to 1 year, and the average of it was 30 d. All the eyes developed the special type RRD, including pseudophakic and aphakic retinal detachment, giant retinal tear with retinal detachment, choroidal detachment associated with retinal detachment, and RRD with ocular dysplasia. In the 14 eyes, there was 2 eyes with retinal detachment in 1 quadrant, 4 eyes in 2 quadrants, 1 eye in 3 quadrants and 7 eyes in total 4 quadrants. All the eyes were treated with 23G or 25G MIVS and filled with irrigation solution, air and silicone oil. In addition, 10.4 months' follow-up for average after surgery were taken to observe the occurrence of retinal reattachment, BCVA and related complications in the eyes. Results In the 14 eyes, 13 (92.9%) of them attained retinal reattachment and 1 eye (7.1%) got a poor retinal reattachment after one operation. At the last follow-up, all the 14 eyes (100.0%) attained retinal reattachment and 5 of them at the filling state of silicone oil. The vision of 8 eyes (57.1%) were improved, 4 eyes (28.6%) have no notable changes and 2 eyes decreased (14.3%). During the operation, iatrogenic retinal breaks were occurred in 1 eye, and silicone oil entered underneath the retina in 1 eye. After the operation, 1 eye suffered a relapse of retinal detachment after the removal of silicone oil and then were filled with it again. Conclusions MIVS is a safe and effective way to treat the special type RRD among the children and adolescents. The rate of retinal reattachment is 92.9% after one surgery and 100.0% at the last follow-up. Therefore, MIVS can help most of eyes with special type RRD to get a stable and improved vision. Key words: Retinal detachment/surgery; Vitreoretinal surgery; Child; Adolescent

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来源期刊

中华眼底病杂志 Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

5383

期刊介绍： Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).