巨大视网膜裂孔的手术疗法和预后

Surgical treatment and outcome of patients with giant retinal tears

Objective. To report the management and outcome in retinal detachments associa ted with giant retinal tears (GRTs). Methods. Retrospective, case note analysis of patients treated between November 1991 and June 2002 at a tertiary referral h ospital. Results. The case notes of 29 patients (24 males, 5 females) with a fol low up ranging from five months to 7 years were reviewed. In all, 25 eyes had r etinal detachments with macular involvement and 10 patients had myopia more than 6 D. All patients underwent vitrectomy. A total of 23 patients had heavy liquid and 16 had scleral explants; 28 patients had silicone oil and one had C3F8 tamp onade. Intraoperative complications included lens trauma and iatrogenic GRT. Six eyes had recurrent retinal detachment and needed multiple surgical procedures. At the last follow up, 25 patients had anatomically attached retinas. In all, 1 8 fellow eyes were treated prophylactically. Three patients had total retinal de tachment and marked PVR. The visual acuity improved in 20 eyes. Conclusion. GRTs are more common in patients with high myopia. With newer techniques of surgical treatment of GRTs, the anatomical and visual outcomes are more favourable.