玻璃体视网膜手术治疗外伤性视网膜脱离合并增生性玻璃体视网膜病变的临床观察

Vitreoretinal surgical for traumatic retinal detachment with proliferative vitreoretinopathy clinical observation

目的：探讨玻璃体视网膜手术（ VRS）治疗合并增生性玻璃体视网膜病变（ PVR）的外伤性视网膜脱离（RD）患者的临床疗效。方法对2007年6月至2013年3月50例（51只眼）合并PVR的外伤性RD患者行VRS治疗，术后随访5～26个月，平均10．8个月。结果视网膜完全解剖复位47只眼，部分复位3只眼，未复位1只眼，总有效率98．4％。视力提高者41只眼（80．39％）；视力不变者7只眼（13．73％），视力下降者4只眼（7.84％）。51只眼均行硅油填充术，继发性青光眼14只眼（27．45％）；8只眼因术后硅油进入前房行前房冲洗术（15．69％）；5只眼视网膜复位后Ⅱ期硅油取出术后低眼压或多次复发RD，长期硅油高粘度填充（9．80％）。结论通过VRS手术能有效解除外伤性PVR引起的视网膜牵拉，复位视网膜，提高视力。

Objective Explore vitreoretinal surgery （ VRS） treatment with proliferative vitreoretinopathy （ PVR） traumatic retinal detachment （ retinal detachment , RD） in patients with recent clinical efficacy .Methods For June 2007-March 2013 50 cases （51 eyes） combined PVR traumatic RD VRS therapy patients were followed up for 5 to 26 months, average 10.8 months.Results 47 full anatomical retinal eye,partial reset three eyes,one eye is not reset, the total effi-ciency of 98.4%.Visual acuity improved in 41eyes （80.39%）;vision unchanged in7eyes （13.73%）;acuity decreased in4eyes （7.84%）.51 eyes underwent silicone oil tamponade , secondary glaucoma,14eyes （27.45%）;8 silicone oil into the anterior chamber of the eye because of postoperative anterior chamber lavage after stage Ⅱ（15.69%）5 retinal silicone oil reset remove or multiple recurrent postoperative hypotony RD , long-term high-viscosity silicone oil filling （ accounting for9.80%） .Conclusion By VRS surgery can effectively relieve the retina caused by traumatic PVR stretch , reset the retina and improve vision.