PVR B级的裂孔性视网膜脱离术后复发与玻璃体病变关系临床分析

The clinical analysis of relationship between postoperative relapse of rhegmatogenous retinal detachment in PVR B and vitreous pathologic change

目的 回顾分析近 10年 PVR B级的裂孔性视网膜脱离术后复发与玻璃体病变的关系。方法 对4 2 9例 (4 35只眼 ) PVR B级的裂孔性视网膜脱离施行巩膜扣带术治疗 ,其中 4 1只眼术后复发 (9.4 3% ) ,分析术后复发与玻璃体病变的关系。结果 术前玻璃体正常组与浓缩组的复发率 (3.19%与 12 .33% )之间差异有显著性 (P<0 .0 5 ) ;正常组与条索牵引组间的复发率 (3.19%与 14 .2 9% )之间差异有极显著性 (P <0 .0 1) ;正常组与总体组的复发率 (3.19%与 9.4 3% )之间差异有显著性 (P <0 .0 5 ) ;术前无玻璃体后脱离组与玻璃体后脱离组间的复发率(5 .5 6 %与 12 .90 % )之间差异有显著性 (P <0 .0 5 )。视网膜脱离术前各种玻璃体的情况在视网膜脱离复发时均有不同程度地加重。结论 PVR B级的裂孔性视网膜脱离术前玻璃体病变和玻璃体后脱离对术后复发影响明显。重视玻璃体—视网膜界面动态变化 。

Objective To study the relationship between postoperative relapse of rhegmatogenous retinal detachment in PVR B and vitreous pathologic change in recent decade.Methods The scleral buckling operation was done for 435 eyes with rhegmatogenous retinal detachment in PVR B.The postoperative relapse was happened in 41 eyes (9.43%).The paper analyzed the relationship between the postoperative relapse and vitreous pathologic change.Results It exists a significant difference (P<0.05) in relapse ratio between the peroperative vitreous normal group and the vitreous condensation group (3.19% and 12.33%),between the preoperative vitreous normal group and the total groups (3.19% and 9.43%) and between the preoperative without posterior detachment of vitreous group and the posterior detachment of vitreous group (5.56% and 12.90%).It also exists a extreme significant difference (P<0.01) in relapse ratio between the preoperative vitreous normal group and the vitreous traction group (3.19% and 14.29%).Various preoperative vitreous states of retinal detachment were separately aggravated when relapsing.Conclusion Pathologic change and posterior detachment of vitreous obviously impact on postoperative relapse of rhegmatogenous retinal detachment in PVR B.It is good for raising the healing ratio when paying more attention to dynamic change on vitro-retinal interface.