玻璃体切割治疗复杂视网膜脱离45例临床分析

Clinical analysis of modern vitrectomy in treatment of 45 cases with complex retinal detachment

目的:分析玻璃体切割术治疗复杂性视网膜脱离的效果。方法:对45例45眼复杂性视网膜脱离眼行闭合式玻璃体切割术,术毕玻璃体腔行C3F8气体或硅油填充。结果:玻璃体切割联合玻璃体腔注气术15眼,1次手术视网膜复位13眼(87%);玻璃体切割联合玻璃体腔内硅油填充术30眼,1次手术完全复位27眼(90%)。统计学检验两组1次手术视网膜复位率的差异无显著意义。术后视力:数指/眼前者2眼,0.02～0.05者3眼,0.06～0.1者10眼,0.12～0.25者19眼,≥0.3者11眼。术中常见的并发症有医源性视网膜裂孔,术后并发症最多见是继发性青光眼和白内障。结论:玻璃体切割联合眼内填充能有效地治疗复杂性视网膜脱离,术后大部分患者视力能得到改善。

AIM：To assess the effectiveness of modern vitrectomy on complex retinal detachment. METHODS：Totally 45 cases （45 eyes） of complex retinal detachment underwent modern vitrectomy combined with 150mL/L C3F8-gas or silicone-oil tamponade. RESULTS：Fifteen eyes underwent vitrectomy with C3F8-gas tamponade,13（87%） eyes achieved retinal reattachment primarily.30 eyes underwent vitrectomy with silicon-oil tamponade,27（90%） eyes achieved retinal reattachment primarily.The comparison between two groups has no significant difference.The visual acuity after operation was counting fingers in 2 eyes; 0.02-0.05 in 3 eyes,0.06-0.1 in 10 eyes;0.12-0.25 in 19 eyes,greater than or equal to 0.3 in 11 eyes. The main complication in operation was iatrogenic slit pore. The main complications after operation were secondary glaucoma and complicated cataract. CONCLUSION：Modern vitrectomy combined with C3F8-gas or silicone-oil tamponade is a useful procedure for complex retinal detachment.The visual acuity of most patients after operation could improve.