玻璃体切除术治疗牵拉性视网膜脱离34例

Vitrectomy in treatment of traction retinal detachment in 34 cases

目的:探讨玻璃体切除术治疗牵拉性视网膜脱离的方法和疗效。方法:各种病因导致的牵拉性视网膜脱离34例36眼,行玻璃体切除术治疗,术后观察视力、视网膜复位情况及手术并发症等,随访3-6(平均3.8)mo。结果:术后视网膜复位,视力有不同程度的提高者32眼(89%);术后3mo内视网膜再脱离4眼,其中2眼经再次手术后复位,2眼眼球萎缩未再手术。手术并发症主要有术中牵拉性裂孔、术中及术后玻璃体积血、术后高眼压、视网膜再脱离等。结论:玻璃体切除术是治疗牵拉性视网膜脱离的有效方法,尤其对于存在广泛固定牵拉、视网膜大范围脱离、玻璃体积血、合并严重的增殖性玻璃体视网膜病变的患者是唯一有效的手术方法。

AIM： To investigate the method and effect of vitrecto my surgery for treatment of traction retinal detachment （tRD）. METHODS： Thirty-four tRD patients （36 eyes） received vitrectomy surgery. Visual acuity, situation of retinal reattachment and surgery complications were observed during the follow-up of 3-6mo （mean 3.8mo） after operation. RESULTS： The retina of 32 eyes （89%）were reattached .Their visual acuity was improved in different levels. Four eyes were re-detached within 3mo after operation. Among the 4 eyes, 2 eyes were repaired after another surgery and 2 eyes were atrophied. The main operation complication include tractional retinal tear, vitreous hemorrhages, hypertony and retinal redetachment. CONCLUSION： Vitrectomy surgery is an effective surgery to treat traction retinal detachment. This surgery is the only effective way to treat tRD with wide-ranging and fixed traction, extensive retinal detachment, vitreous hemorrhage and severe proliferative vitreoretinopathy （PVR）, etc.