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目的 探讨视网膜脱离 (retinaldetachment,RD)手术对患者视网膜和视乳头血流的影响。方法 应用共焦扫描激光多普勒视网膜血流分析仪 (heidelbergretinaflowmeter,HRF)检测 6 2例 (6 2只眼 )单眼孔源性RD术后患者的视网膜和视乳头血流参数。其中 34只眼采用玻璃体视网膜(vitreoretinal,VR)手术 ,2 8只眼采用常规巩膜扣带 (scleralbucking ,SB)术 ,手术方式包括巩膜环扎术、巩膜外冷冻术、晶状体或玻璃体切除术、眼内激光光凝术 ,术中应用全氟萘烷液体、长效气体及硅油填充等。结果 RD组与对照组比较 ,眼底血流量、血流速及红细胞移动速率均降低 ,颞侧视乳头盘沿及鼻侧视乳头盘沿的红细胞移动速率差异均有显著意义 (P <0 0 5 ) ;视乳头大血管血流量、血流速及红细胞移动速率 ,颞侧、鼻侧视乳头盘沿的血流量及血流速 ,颞侧、鼻侧视乳头旁视网膜血流量相比较 ,差异均有非常显著意义 (P <0 0 1)。VR术组与SB术组比较 ,其血流量、血流速及红细胞移动速率均明显降低 ;颞侧、鼻侧视乳头盘沿 ,鼻侧视乳头旁视网膜的红细胞移动速率 ,颞侧视乳头旁视网膜的血流速比较 ,差异均有显著意义 (P <0 0 5 )。硅油填充组与未填充组比较 ,其眼底血流量、血流速及红细胞移动速率均降低 ;其中鼻侧视乳头盘沿及鼻侧视乳头
Objective To investigate the effect of retinal detachment (RD) surgery on retinal and optic nerve blood flow in patients. Methods Confocal laser Doppler retinal hemorrhage analyzer (heidelberg retina flowmeter, HRF) was used to detect the retinal and papillary blood flow parameters in 62 patients (62 eyes) with monocular rheumatoid arthritis. Of these, 34 eyes were treated with vitreoretinal (VR) surgery and 28 eyes were treated with conventional scleral buckling (SB). Surgical procedures included scleral cerclage surgery, extra-scleral cryotherapy, lensectomy or vitrectomy, Within the laser photocoagulation, intraoperative application of perfluorodecalin liquid, long-acting gas and silicone oil filled. Results Compared with the control group, the retinal blood flow, blood flow velocity and erythrocyte migration rate were decreased in RD group, and the differences of red blood cell migration rate between temporal pannus and nasal papilla were significant (P <0.05 ). The blood flow of blood vessels, blood flow velocity and erythrocyte migration rate in the optic nerve, blood flow in the temporal and nasal papillae, blood flow velocity in the temporal and nasal papillae, There was a significant difference (P <0.01). Compared with SB group, the blood flow, blood flow rate and erythrocyte migration rate were significantly decreased in VR group and SB group. The temporal and nasal optic disc rim, Retinal blood flow velocity comparison, the difference was significant (P <0 05). In the silicone oil-filled group, the fundus blood flow, blood flow velocity and erythrocyte migration rate decreased compared with the unfilled group, in which the nasal optic disc rim and the nasal optic disc