435例玻璃体切除术的病因及疗效分析

Clinical analysis of the etiological factors and the clinical outcomes of vitrectomy in 435 cases

目的分析玻璃体切除手术的常见病因及探讨其手术疗效。方法 2014年7月至2016年6月在我科行玻璃体切除手术治疗的435例(440只眼)患者进行回顾性分析。结果孔源性视网膜脱离193只眼(43.86%)、糖尿病视网膜病变116只眼(26.36%)、眼外伤50只眼(11.36%)、视网膜静脉阻塞47只眼(10.68%),共占92.26%,为行玻璃体切除手术的主要原因,其它少见原因分别为老年性黄斑变性、单纯视网膜裂孔所致玻璃体积血、高血压视网膜病变、白内障术后玻璃体积血或脉络膜上腔出血、全葡萄膜炎、人工晶状体移位、视网膜血管炎等。手术前后视力比较有显著差异(P<0.01)。结论孔源性视网膜脱离、糖尿病视网膜病变、外伤、视网膜静脉阻塞是玻璃体切除手术的主要病因,玻璃体切除手术是其治疗的有效方法。

Objective To analyze the etiological factors of vitrectomy and explore the clinical outcomes of vitrectomy. Methods A retrospective analysis was performed on 435 patients（ 440 eyes） who underwent vitrectomy in our hospital from July 2014 to June 2016. Results The main etiological factors of vitrectomy was found in 193 eyes of rhegmatogenous retinal detachment（ 43. 86%）,116 eyes of diabetic retinopathy（ 26. 36%）,50 eyes of ocular trauma（ 11. 36%）,47 eyes with retinal vein occlusion（ 10. 68%）,amounting to 92. 26% of the total eyes. Other rare factors were senile macular degeneration,retinal vitreous caused by simple hemorrhage,retinopathy caused by hypertension,postcataract surgery vitreous hemorrhage or choroidal hemorrhage,panuveitis,IOL dislocation,retinal vasculitis and so on. There were significant differences in visual acuity before and after operation（ P 0. 01）. Conclusion Rhegmatogenous retinal detachment,diabetic retinopathy,trauma and retinal vein occlusion are the main factors of vitrectomy. Undergoing vitrectomy in time can help to improve the visual acuity.