首选玻璃体手术治疗脉络膜脱离型视网膜脱离的疗效分析

The Curative Effects of Primary Vitrectomy in treatment of Rhegmatogenous Reinal Detachment associated with Choroidal Detachment

目的评估首选玻璃体手术治疗无明显PVR的脉络膜脱离型视网膜脱离的疗效。方法选取32例(32只眼)脉络膜脱离型视网膜脱离,PVR低于C1,常规应用糖皮质激素同时尽快采用玻璃体手术,放脉络膜上腔积液,硅油填充或膨胀性气体填充,并酌情联合巩膜扣带术。所有病例术后随访3个月以上。结果黄斑裂孔者17例,27例无PVD,一次手术复位率为87．5％(28/32),有2例2或3次手术成功,余下2例失败。结论对无明显PVR的脉络膜脱离型视网膜脱离首选玻璃体手术,有利于减少PVR的发生和提高手术复位率。

Objective To evaluate the curative effects of primary vitrectomy in treating the patients with rhegmatogenous retinal detachment associated with choroidal detachment but without obvious PVR. Methods 32 cases (32 eyes) of rhegmatogenous retinal detachment associated with choroidal detachment with proliferative vitreoretinopathy less than grade C1 were included. They were treated with steroids followed by pars plana vitrectomy as soon as possible. In the operation, drain the subretinal fluid through the vitrectomy sclerotomies. Postoperative tamponade was done by silicone oil or dilatable gas. Encircling scleral buckle placed in some cases when they were needed. All cases were followed up for at least 3 months. Results 17 cases with macular hole, 27 cases without PVD, retinal reattachment was attained in 28 eyes, of other 2 cases were achieved by two or three surgeries, and the remainder 2 cases failed. Conclusion Primary vitrectomy in treating cases with rhegmatogenous retinal detachment associated with choroidal detachment with proliferative vitreoretinopathy less than grade Cl could increase the rate of retinal reattachment, and decrease the occurrence of PVR after surgeries.