晶体玻璃体视网膜联合手术治疗复杂性视网膜脱离

Lenticular-vitreoretinal surgery for complicated retinal detachment

目的探讨玻璃体视网膜手术（ｖｉｔｒｅｒｅｔｉｎａｌｓｕｒｇｅｒｙ，ＶＲ术）联合晶体切除／超声粉碎的效果。方法对８１例（８１只眼）应用晶体玻璃体视网膜联合手术（ｌｅｎｔｉｃｕｌａｒ－ｖｉｔｒｅｏｒｅｔｉｎａｌｓｕｒｇｅｒｙ，ＬＶＲ术）治疗的复杂性视网膜脱离进行回顾性分析。结果解剖性成功者６４只眼（７９．０１％），功能性成功者４５只眼（５５．５６％）；手术成功率显著降低的原因是前部增殖性玻璃体视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｖｉｔｒｅｏ－ｒｅｔｉｎｏｐａｔｈｙ，ＰＶＲ）（成功率４２．８６％，Ｐ＜０．０１）和术中／术后眼内出血（成功率５８．８２％，Ｐ＜０．０２５）。结论ＬＶＲ术是治疗复杂性视网膜脱离的主要方法；显著影响手术预后的因素是前部ＰＶＲ和术中／术后眼内出血。

Objictive To study the efficacy of vitreoretinal(VR)surgery combined with lensecto my/ultrasonic fragmentation.Methods Eight one patients (eyes) with complicated retinal detachment treated with combined lenticular vitreoretinal(LVR) surgey were reviewed retrospectively.Results Anatomic success was achieved in 64 (79.01%) eyes,and functional success in 45 (55.56%) eyes.Ante rior proliferative vitreoretinopathy (PVR) and intraocular hemorrhage (IOH) significantly reduced the anatomic success rate to 42.86% (P<0.01) and 58.82% (P<0.025) respectively.Conclusion LVR surgery plays an important therapeutic role in treatment of complicated retinal detachment.The significant factors affecting the surgical outcome are anterior PVR and intra /post operative IOH.