巩膜扣带术后视网膜脱离

Recurrent retinal detachment after scleral buckling

目的 分析巩膜扣带术后视网膜脱离形成的原因和玻璃体手术治疗方法。方法 回顾 4 6例 (46只眼 )孔源性视网膜脱离患者的临床资料及其手术治疗方法。结果 巩膜扣带术后 2 4只眼出现新孔 ,其中 7只眼为黄斑部裂孔 ;18只眼 PVR发展 C级以上 ;5只眼原裂孔未封闭 ;5只眼合并有脉络膜脱离 ;这些因素导致 35只眼视网膜下液持续不吸收。 38只眼玻璃体手术后视网膜复位 ,占 82 .6 % ;多次手术后最终手术成功 4 5只眼 ,成功率为97.8%。结论 巩膜扣带术后失败原因主要为新孔的发生、PVR发展和视网膜下液不吸收 ;再次玻璃体手术时 ,掌握手术时机 ,对症处理 。

Objective To analyze the causes and treatment for recurrent retinal detachment after scleral buckling.Methods 46 eyes of 46 cases of rhegmatogenous retinal detachment(RD)were reviewed in clinical materials and operation procedures.Results Redetachment after scleral buckling was due to new retinal breaks in 24 eyes,in which 7 eyes had a macular hole,Proliferative vitreoretinopathy(PVR)(≥Grade-C)development in 18 eyes,reopening of original breaks in 5 eyes,choroidal detachment in 5 eyes.Those factors led to subretinal fluid(SRF)unabsorbed in 35 eyes.Reatachment rate was 82.6% after vitrectomy,and the final anatomical success rate was 97.8%.Conclusions The primary causes after scleral buckling were new retinal breaks,PVR development and SRF unabsorbed.The key to promote operation success rate is mastering opportunities and the proper treatments of vitrectomy.