孔源性视网膜脱离复位后再脱离的主要原因分析

Analysis of main causes for redetachment of rhegmatogenous retinal detachment

目的分析我院眼科中心2014年1月~2016年12月间孔源性视网膜脱离手术复位后再脱离的主要原因。方法对2014年1月~2016年12月间53例复发性视网膜脱离53只眼进行回顾性分析。采用Wilcoxon秩和检验对两次手术前视网膜裂孔大小构成比进行统计分析;采用χ~2检验对裂孔位置进行统计分析;采用Wilcoxon秩和检验对两次手术前的PVR级别进行统计分析。结果两次手术前裂孔大小的构成比存在统计学意义(Z=-2.109,P=0.035)。第2次手术<1PD的小裂孔明显增多。两次手术前裂孔的位置存在显著性差别(χ~2=13.523,P=0.001)。第2次手术中下方视网膜裂孔的病例数增多。第2次手术前PVR程度较第1次严重(Z=-4.354,P<0.01)。结论新裂孔形成和增殖性玻璃体视网膜病变是孔源性视网膜脱离术后复发的主要原因。新裂孔的形成以小裂孔及下方裂孔为多见。

Objective To analyze the main reasons of surgical reduction of rhegmatogenous retinal detachment after detachment in the Ophthalmic Center of Foshan Second People＇s Hospital from January 2014 to December 2016. Methods A retrospective analysis of 53 cases with recurrent retinal detachment from January 2014 to December 2016 was performed in 53 eyes.Retinal hole size proportion before surgery were analyzed with the Wilcoxon rank test. Chi square test was used for statistical analysis of the hole location.PVR level before the two operation were analyzed using the Wilcoxon rank test. Results There was significant difference in the proportion of the size of the hiatus before the two operation （Z=-2.109,P=0.035）.The small hole in the second operation less than 1PD was significantly increased.There was significant difference in the location of the hiatus before the two operation （Z2=13.523,P=0.001）. The number of inferior retinal holes were increased during the second operation.The degree of PVR was significantly lower than that of the first before the second operation （Z=-4.354,P 〈 0.01）. Conclusion The formation of new holes and proliferative vitreoretinopathy （PVR） are the major causes of recurrent retinal detachment. Small breaks and inferior breaks are more common.