孔源性视网膜脱离手术后复发38例临床分析

Clinical analysis of 38 cases of recurrent rhegmatogenous retinal detachment

目的 探讨孔源性视网膜脱离手术后复发原因并提出初步处理对策。方法 回顾分析38例孔源性视网膜脱离手术后复发病例的临床资料。38例(38只眼)术前行常规眼部检查后给予手术治疗，包括硅胶垫压、冷凝、放液、环扎及玻璃体切割加气液交换。结果 复发原因包括新裂孔形成、原裂孔封闭不良、裂孔漏查、视网膜下液未排净，新发生及加重的PVR。33只眼经二次手术视网膜复位。结论 术前详细检查玻璃体视网膜、术中确切封闭视网膜裂孔、选择合理术式避免医源性PVR是手术成功的关键。对于常规手术能解决问题的复发病例可不选择玻璃体手术。

Objective To investgate the causes of recurrent rehgmatogenous retinal detachment and offer some dealing Methods Retrospectively analyze the clinical data of 38 cases of recurrent rehgmatogenous retinal detachment which were routinely examined preoperatively and surgically treated including scleral buckling, cryopexy, external drainage and vitreous surgery with gas - liquid exchange. Results The causes of recurrent rehgmatogenous retinal detachment include new breaks formation,inadequately closed breaks , missed breaks as well as new or aggravated PVR. 33 eyes were reattached after a second surgery. Conclusion The successful surgery rely on preoperative examination , precise closing of retinal breaks, proper selection of surgical method as well as avoidance of iagefic PVR.