增殖性玻璃体视网膜病变的玻璃体手术治疗

Vitrectomy for proliferative vitreoretinopathy

目的 :评估玻璃体手术治疗增殖性玻璃体视网膜病变 ( proliferative vitreo- retinopathy,PVR)的疗效。方法 :C2 级以上 PVR合并视网膜脱离 2 1眼 ,其中特发性 PVR14眼 ,外伤性 PVR7眼 ;C级 9眼 ,D级12眼 ,均作常规玻璃体切除术联合巩膜环扎、膜剥离、松解性视网膜切开、气体或硅油填充等附加术式。结果 :出院时 2 1眼视网膜全部复位 ( 10 0 % ) ,19眼随访 2～ 9个月 ,视网膜复位成功率为 78.9% ( 15 / 19) ,术后视力提高 95 .2 % ( 2 0 / 2 1)。 4眼手术失败 ,均系 PVR再次复发所致。结论 :玻璃体手术是治疗严重 PVR的理想术式。术中技巧在于剥膜、解除基底部玻璃体对视网膜的牵引。手术失败的主要原因是

Objective:To evaluate the effect of vitrectomy in the proliferative vitreoretinopathy(PVR).Methods:21 cases of PVR(≥Grade-C2) with retinal detachment were treated by vitrectomy and scleral encircling buckling, membrane peeling, retinotomy, and gas or silicon oil tamponade.Results:The retina was reattached in a rate of 78.9% in 2～9 months postoperatively, visual acuity improved significantly in 20 eyes(95.2%). 4 eyes failed because of PVR recurrent.Conclusion:Modern vitrectomy is optimal operation for PVR. The most important technique is membrane peeling and eliminating the traction of vitreous base. PVR recurrent is major cause of failure.