复杂性视网膜脱离的玻璃体切除术联合SF_6或硅油填充的手术复位率比较

A comparison of attachment rates between SF_6 and silicone oil tamponades following vitrectomy for treatment of complicated retinal detachment

对增殖性玻璃体视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｖｉｔｒｅｏｒｅｔｉｎｏｐａｔｈｙ，ＰＶＲ）的孔源性视网膜脱离、巨大裂孔和黄斑裂孔性视网膜脱离、眼球穿通伤性视网膜脱离以及视网膜血管性疾患引起的牵拉合并裂孔性视网膜脱离计２１５例，分别进行了首次或再次玻璃体切除手术并对术中使用ＳＦ＿６或硅油填充的复位率进行了比较。结果显示，在ＰＶＲ视网膜脱离Ｃ期、巨大裂孔性视网膜脱离合并ＰＶＲＣ＿２期以下改变以及黄斑裂孔性视网膜脱离中，ＳＦ＿６或硅油填充均有效高的复位率。ＰＶＲ视网膜脱离Ｄ期、大于１８０°的巨大裂孔或巨大裂孔合并≥ＰＶＲＣ＿３期、眼穿通伤性和视网膜血管性疾患致牵拉裂孔性视网膜脱离眼，ＳＦ＿６填充的复位率低，而硅油填充仍显示较高的复位率。

In this study,215 eyes with rhegmatogenous retinal detachment and proliferative vitreo-retinopathy(PVR)including giant tears,macular holes,perforating injury and traction caused by reti-nal vascular diseases were treated by vitrectomy and SF_6 or silicone oil.The anatomic attachment rates were compared between gas and silicone oil groups in non-vitrectomized eyes and previously vitrec-tomized eyes, respectively. Both gas and silicone oil groups showed higher attachment rates in stage C of PVR,giant tears with PVR less than stage C_2 and macular holes.The gas group showed lower attach-ment rates in cases with stage D of PVR,giant tear larger than 180°or with PVR C_3 or greater than C_3,after perforating injury and traction-rhegmatogenous retinal detachment, while silicone oil group showed better attachment rates. The choice of tamponades should be based on different indications.