视网膜脱离巨大裂孔与预后分析

Analysis in the Shape and Prognosis of Giant Retinal Tears

目的探讨视网膜脱离巨大裂孔形态与视网膜瓣翻转的关系、手术适应症及预后的关系．方法回顾1994年1月至1996年6月我院收治的巨大裂孔视网膜脱离72例73眼，单纯型5眼，复杂型68眼．放射状撕裂38眼。手术方法基本分为五种类型。结果单纯型均为非撕裂型．撕裂型巨大裂孔易致度数扩大，视网膜后瓣翻转严重，选择玻璃体手术，结合或不结合环扎加压水，冷凝及激光封孔，总痊愈率为78．0％；根据适应症选择合适的各种手术，其痊愈率无明显差异（P＞0．05）。结论巨大裂孔形态及巨大裂孔后瓣视网膜翻转程度有明显关系，选择合适的手术能进一步提高治愈率，封闭裂孔是极其重要的。

To evaluate a group of clinical associations between the shapes and the degree of inverted retinal flap. surgical indications and prognosis in giant retinal tears. Methods Seventy - three eyes of 72 patients with retinal detachment of giant tears from January 1994 to June 1996 were reviewed. The patients were divided into simple type in 5 eyes, complicated type in 68 eyes and the end of inverted retina with radialized tear in 38 eyes.Five surgical approaches were performed in thses patients. Results All of the eyes with simple type were not presented radialized tear. In those eyes with radialized teat. the retina tend to expand the degree of the giant tears and show the inarked inverted retinalnap, the different and appropriate surgical techniques were selected, including vitrectomy with or without encircle scleral buckling, cryopexy or photocoagulation for the giant tears. Total rate of the anatomic retinal reattachment was 78. 08％. The success rates of the different surgical procedures based on individual cases have no obvious difference (P >0.05). Conclusion Thereis very closed relationship between the shape and degree of inverted retinal flap in giant retinal tears. To select a proper surgical procedure and to close the giant tears will improve the success rate.