孔源性视网膜脱离行巩膜扣带术后屈光状态变化

Changes of Refractive State after Scleral Buckling for Rhegmatogenous Retinal Detachment

摘要: 目的：观察孔源性视网膜脱离(RRD)行巩膜扣带术后其最佳矫正视力(BCVA)、角膜曲率、前房深度、晶状体厚度及眼轴的变化。方法：采用临床回顾性研究，对30例30眼RRD患者进行巩膜扣带术治疗，其中20眼行巩膜外垫压术，10眼行巩膜环扎术。术后每月随访一次，随访期间进行测量患者的最佳矫正视力(BCVA)、角膜曲率、前房深度、晶状体厚度及眼轴的变化。结果：30眼均完成随访6~12月，巩膜扣带术术后等效球镜较前变大，两种术式后BCVA较前提高、角膜垂直曲率较前变大、前房较前变浅、晶状体较前变厚，但角膜水平曲率无明显变化。巩膜环扎术后眼轴变化明显，巩膜外垫压术后角膜曲率变化明显。巩膜环扎术后变化较巩膜外垫压术后明显。随访期间未发现全身不良反应及眼部严重并发症。结论：孔源性视网膜脱离行巩膜扣带术后屈光度负性增加，其中环扎术后以眼轴变化明显，外垫压术后以角膜曲率变化明显，前房深度及晶状体厚度变化亦参与其中。

Abstract: Objective: To observe the changes of the best corrected visual acuity (BCVA), corneal curvature, anterior chamber depth, lens thickness and eye axial after scleral buckling with rhegmatogenous retinal detachment (RRD). Methods: We use a clinical retrospective study. 30 cases (30 eyes) of RRD were treated with scleral buckling, of which 20 eyes were treated with scleral padding and 10 eyes were treated by scleral encircling. The changes of BCVA, corneal curvature, anterior chamber depth, lens thickness and eye axis were measured during follow-up. Results: 30 eyes were followed up for 6 to 12 months. After scleral buckling, the equivalent spherical lens became larger, the BCVA was higher, the corneal vertical curvature was larger, the anterior chamber was shallower, and the anterior lens thickened. However, there was no significant change in the horizontal curvature of the cornea. The change of corneal curvature after scleral padding was obvious, and the change of eye axis after scleral encircling was obvious. The changes after scleral encircling were more obvious than those after scleral padding. No systemic adverse reactions or serious ocular complications were found during the follow-up period. Conclusions: After scleral buckling, the diopter of rhegmatogenous retinal detachment increased significantly, the eye axis changed obviously after scleral encircling, the corneal curvature changed obviously after scleral padding, and the changes of anterior chamber depth and lens thickness were also involved.