目的 研究巩膜外垫压手术联合视网膜激光光凝对硅油眼视网膜脱离的治疗效果。 方法 回顾性分析2009年1月－2012年1月，用巩膜外垫压联合视网膜光凝手术治疗36例硅油眼视网膜脱离的视网膜复位效果。 结果 全部患者均顺利完成巩膜外垫压手术及随后的视网膜激光光凝，行巩膜外放液5只眼，手术中未发生视网膜嵌顿、眼内出血和眼压显著升高等并发症；手术后1周视网膜复位21只眼（58.33%），剩下15只眼1个月后复位7只眼（19.44%），视网膜脱离总复位率为28只眼（77.77%）；未复位8只眼（22.23%），改用玻璃体切割手术方式，视网膜成功复位；6个月后取出硅油，随访6个月视网膜无脱离或者脱离范围增加；手术后眼压≥30 mm Hg （1 mm Hg=0.133 kPa）3只眼，≥20 mm Hg 7只眼，对症治疗1周后眼压均恢复到正常范围。 结论 巩膜外垫压联合视网膜激光光凝治疗硅油眼视网膜脱离，手术简单，复位率高，可为硅油眼视网膜脱离首选手术方式，对于巩膜外垫压手术失败和复杂的硅油眼视网膜脱离，应当选择玻璃体切割手术方式。
Objective To investigate the time l imit of repairing old sciatic nerve defect in rats and observe the repair effect of autogenous nerve transplantation on old sciatic nerve defect in rats. Methods Thirty-six SD rats of clean grade wererandomized into 6 groups (n=6 per group). The animal model of nerve defect was made by transecting left sciatic nerve at the mid-thigh level. For groups A1, B1 and C1, defects were repaired by the contralateral autogenous nerve transplantation 1, 3 or 6 months after nerve damage and for the control groups of A2, B2 and C2, defects were not repaired. After operation, the gait, toe skin and leg muscle were examined weekly. Three months after autograft, a combination of electrophysiology examination, fluoro gold (FG) retrograde tracing and histological assessment including l ight microscopy, TEM was util ized to investigate the nerve functional recovery. Results Lameness and foot skin ulcers were observed in each group after nerve damage. At 2 months after autograft, such denervation symptoms were only improved in groups A1 and B1. At 3 months after autograft, the motor conduction velocity was (21.84 ± 6.74), (20.02 ± 4.17) and (16.09 ± 8.21) m/s in groups A1, B1 and C1, respectively, showing no statistically significant difference between them (P gt; 0.05). The ampl itude of compound muscle action potential (CAMP) was (12.68 ± 4.38), (9.20 ± 3.43) and (1.22 ± 0.39) mV in groups A1, B1 and C1, respectively, indicating significant differences between groups A1, B1 and group C1 (P lt; 0.05). No CAMP was evident in groups A2, B2 and C2. FG retrograde tracing conducted 3 months after autograft showed that the positive cells were most common in group A1 with big soma, mild in group B1 and lest in group C1 with smallest soma. Gastrocnemius Masson staining showed that the fiber morphology of gastrocnemius in groups A1 and B1 was close to normal, while the rest 4 groups had an obvious atrophy of muscle fiber. The fiber cross-section area was (340.73 ± 118.46), (299.88 ± 119.75), (54.33 ± 53.43), (78.60 ± 51.38), (65.62 ± 25.36), and (40.93 ± 28.22) μm2 in groups A1, B1, C1, A2, B2 and C2, respectively, indicating a significant difference between groups A1, B1 and groups C1, A2, B2 (P lt; 0.05). Neurohistology observation showed that more regenerated nerve fibers were observed in group A1 and B1, but less in group C1. The myel in sheath was thick in groups A1 and B1, while it was thin in group C1. Only SCs and hyperplastic collagen fiber were found in groups A2, B2 and C2. Conclusion Autogenous nerve transplantation is capable of repairing 1- and 3- month sciatic nerve defect to some degree in rat, but repair effect is not obvious on 6-month sciatic nerve defect in rats.