增殖性玻璃体视网膜病变性视网膜脱离的手术治疗

SURGICAL TREATMENT FOR RETINAL DETACHMENT WITH PROLIFERATIVE VITREORETINOPATHY

报告１８９例１８９眼严重增殖性玻璃体视网膜病变（ＰＶＲ）性视网膜脱离，单纯巩膜扣带术和玻璃体切除术的结果，平均解剖成功率６３％，从Ｃ１８７．５％至Ｄ３３０．４％。术后复位成功的病例９５．８％有指数以上的视力，但仅２６．９％达０．１以上，且多集中于Ｃ１和Ｃ２组。手术失败的主要原因是新的或复发的前段ＰＶＲ形成（５１．４％），其次为后部视网膜前膜增殖，将原裂孔拉开或形成新裂孔（２５．７％）。就ＰＶＲ性视网膜脱离的手术时机，手术方式及前段ＰＶＲ的形成进行了讨论。

ne hundred and eighty-nine cases of retinal detachment complicated with advanced pro-liferative vitreoretinopathy(grade C or D)were treated with scleral buckling or vitreoussurgery,The reattachment rate was63%.ranging from 87.5%in grade C1 to 30.4%in gradeD3.Retinas were reattached in 119,of which the postoperative visual acuity was counting fin-ger or better in 95.8%and 20/200 or better in 26.9%in those cases,of grade C1 to C2 with-out proliferative vitreoretinopathy;The major causes of surgical failure weredevelopment ofnew or recurrent anterior PVR(51.4%)posterior epiretinal proliferation making pre-exist-ing retinal breaks open and creation of new breaks(25.7%).Finally,we discussed the time ofvitreoretinal surgery,methods of operation and the formation of anterhr PVR.