Observation On The Effect Of Modified Minimal Scleral Buckling Surgery For Rhegmatogenous Retinal Detachment

Objective:To observe the effect of modified minimal scleral buckling surgery on rhegmatogenous retinal detachment.Methods:This is a prospective continuous study.A total of 20 eyes of 20 patients with rhegmatogenous retinal detachment diagnosed in the Second Hospital of Jilin University from December 2018 to December2019 were included in the study.Performed a modified minimal scleral buckle surgery.BCVA,mydriatic fundus examination,intraocular pressure,corneal curvature,axial length,corneal topography and other examinations were performed before and after the operation to analyze the therapeutic effect before and after treatment.The size,position and length,width,and height of the retinal hole and the trimmed silicone sponge pad were recorded in detail.The data was analyzed using SPSS25.0 statistical analysis software.Results:BCVA was significantly improved at any stage after the operation compared with that before the operation,and the difference wasstatistically significant(P = 0.003;P = 0).There was no significant change in visual acuity at 3 months and 6 months after the operation,and the difference was not Statistical significance(P = 0.884).The intraocular pressure was within the normal range at 3 days after surgery,but it was significantly higher than at any stage before surgery,and the difference was statistically significant(P <0.05),1 week after surgery,1month after surgery,3 months after surgery,There was no significant change in intraocular pressure at 6 months after operation and preoperative intraocular pressure,and the difference was not statistically significant(P = 1).Although the length of the eye axis increased at 1month,3 months,and 6 months after operation,the difference was not statistically significant(P = 0.322;P = 0.370;P = 0.349);The depth of the anterior chamber was significantly shallower 1 month after the operation than before the operation,and the difference was statistically significant(P = 0.018).Compared with the preoperative 3 months and 6months after the operation,the difference was not statistically significant(P = 0.093;P = 0.826).The thickness of the lens increased significantly at 1 month after operation compared to before operation,and the difference was statistically significant(P = 0.043).At 3 months and 6months after operation,the difference was not statistically significant(P= 0.685;P = 0.631).The corneal curvatures K1 and K2 all changed significantly at 1 month after operation,and the difference wasstatistically significant(P = 0.008;P = 0.019),and gradually decreased thereafter.At 3 months after surgery,K1 was still statistically different from that before surgery(P = 0.015).At 6 months after surgery,K1 and K2 had returned to the preoperative baseline.Although the astigmatism on the anterior and posterior surfaces of the cornea increased 6 months after surgery,the difference was not statistically significant(P = 0.646;P= 0.743).The one-dimensional linear regression model established between the span of the hole and the length of the cushion pressure block fits well(R2 = 0.915> 0.8).The linear relationship regression model established by independent variable(X)"cracking span" and dependent variable(Y)"pad length" has significant statistical significance(P = 0).Conclusion:1.The modified minimal scleral buckling surgery significantly improves the patient's vision and resets the detached retina.2.The patient's intraocular pressure increased temporarily after the modified minimal scleral buckling surgery,but the intraocular pressure was within the normal range.3.Modified minimal scleral buckling surgery is safe and effective for simple rhegmatogenous retinal detachment,and has little effect on the refractive state.4.In this study,the silicone sponge was quantified and the half ofthe original silicone sponge height was removed.The mattress suture span was unchanged,reducing the height of the surgical crest and reducing the degree of eyeball deformation.The use of 2 to 3mm high silicon sponge can form an ideal surgical crest.5.In this study,the scope of the cut of the conjunctiva was reduced.According to the span of the hole,1 or 2 quadrants of the conjunctiva were partially cut and three straight muscle traction lines were made.6.The linear relationship regression model established by independent variable(X)"cracking span" and dependent variable(Y)"pad length",the model expression is: Y = 0.138 X + 7.534.For example,when the crack span is 1 hour,no matter how large or how large the crack is,an average of 11.674 mm long silicon sponge pad pressure can be used to close the crack.