Observation On Surgery For Retinal Detachment With Congenital Choroidal Coloboma

[Objective] To investigate and analyze clinical characteristics and effects of surgery forretinal detachment with congenital choroidal coloboma.[Methods] January2002to December2012in AnHui Provincial Hospital,55cases (16eyes)with congenital choroidal coloboma associated with retinal detachment.There are9eyes of female patients and47eyes of male patients aged from8to40years old(20.0±7.9years old average),including31right eyes and25left eyes.Course of diseaseabout eight days to3months, an average of13.4days.Including coloboma of iris26eyes,coloboma of optic disc13eyes.of49eyes retinal detachment range are up to theedge of the coloboma.All the eyes underwent pars plana vitrectomy with internaltemponade using silicone oil (42eyes) or C3F8gas (14eyes).They were in proneposition after surgery at least2weeks.All patients were followed up6~12months toevaluate and observe eyesight improvement and retinal reattachment.Recordpreoperative and postoperative visual acuity，and the results of intraocularpressure,B-mode ultrasonic diagnostic and optical coherencetomography.Application,SPSS17.0package for statistic analysis,using chi-square testand Fisher test,to P<0.05was considered statistically significant.[Results]42eyes underwent pars plana vitrectomy with internal temponade usingsilicone oil and37eyes with retina reattached after one surgery.The disposablepostoperative reset rate is88.1%.14eyes underwent pars plana vitrectomy with internaltemponade using C3F8and8eyes with retina reattached after one surgery.Thedisposable postoperative reset rate is57.1%.There is statistically significant differencein retina reattachment between PPV with silicone oil and PPV with C3F8group(P<0.05).The visual acuity improvement rate is90.5%(38eyed) in PPV with silicone oil group,and it is57.1%(8eyes) in PPV with C3F8group.There is statisticallysignificant difference in visual acuity improvement rate between these two groups(P<0.05).The intraocular pressures of the first day、the second day after surgery werestatistically significant difference between the two groups.[Conclusion] The treatment of retinal detachment with congenital choroidal colobomamainly is pars plana vitrectomy.In the process of operation,with high power microscopeand intraocular lighting system can find the defect area in retina.Along the edge of thechoroid defect with normal retina,using condensation and laser photocoagulation,toadhesion the retina and choroid.Make the normal retina and retinal separate defect areais one of the effective methods to prevent the net to take off the continueddevelopment.The improvement of eyesight after the operation are fully affirmed.