玻璃体切割术后视网膜脱离分析

Retinal detachment after pars plana vitrectomy

目的 探讨玻璃体切割术后视网膜脱离的原因、特点、治疗方法。方法 回顾分析我科近年发生的 16例玻璃体切割术后视网膜脱离的特征及治疗过程。结果 发生率为 6% ,其中增生性糖尿病视网膜病变 4例 ,非糖尿病性玻璃体混浊 12例 ,75 %于术后 1周内出现视网膜脱离 ,69%由医源性裂孔引起。二次手术治疗包括玻璃体切割、经巩膜视网膜冷冻、巩膜扣带、长效气体及硅油充填术。最终 81%视网膜复位、视力提高。结论 玻璃体切割术中应从各个环节防止视网膜的损伤 。

ObjectiveTo investigate the cause,characteristics and treatment of retinal detachment after pars plana vitrectomy.MethodsThe causes and treatments of 16 cases with retinal detachment after pars plana vitrectomy in our department were analyzed retrospectively.ResultsThe incidence of retinal detachment was 6%.The study included 4 cases of proliferative diabetic retinopathy(PDR)and 12 cases of non diabetic vitreous opacities.Retinal detachment was found within the first week after operation in 75% of the eyes,and were caused by iatrogenic retinal breaks in 69% of the eyes.Reoperations included further vitrectomy,transcleral cryotherapy,buckling,long effect gas and silicone oil temponade.In the end,retinal reattachment with visual acuity improvement was obtained in 81% of the cases.ConclusionAll efforts should be made during vitrectomy to avoid injuries to the retina.After reoperation,retinal reattachment could be obtained in most cases.