开放性眼外伤玻璃体切除术后视网膜脱离的原因分析

Analysis on the cause of retinal detachment after vitrectomy for open ocular trauma

目的分析开放性眼外伤玻璃体切除术后发生视网膜脱离的原因。方法对该院2013年7月至2018年7月接受Ⅱ期玻璃体切除术129例开放性眼外伤的临床资料进行回顾性分析。术后随访中视网膜在位114例纳入在位组,视网膜脱离15例纳入网脱组。分析开放性眼外伤术后视网膜脱离新发生或复发的影响因素。结果两组患者性别、年龄及受伤类型等基本情况比较差异无统计学意义(P>0.05)。术后出现视网膜脱离的因素:网脱组患者术前合并增生性玻璃体视网膜病变(PVR)的比例较在位组高(P=0.002);术前合并视网膜脱离者比例较高(P=0.032),手术时间较晚(P<0.001),术中进行巩膜外冷凝和视网膜切开术者比例较高(P=0.020,0.000)。结论PVR、原有视网膜脱离、晚期手术及术中过度操作是造成开放性眼外伤术后发生或复发视网膜脱离的主要原因。

Objective To analyze the causes of retinal detachment in patients with open ocular trauma after vitrectomy.Methods The clinical data of 129 patients with open ocular trauma underwent vitrectomy from Jul.2013 to Jul.2018 were retrospectively analyzed.A total of 114 patients in the non-retinal detachment group and 15 patients in the retinal detachment group were included.The cause of retinal detachment after vitrectomy for open ocular trauma were analyzed.Results There was no significant difference in gender,age or type of injury between the two groups(P>0.05).The factors of postoperative retinal detachment were related to combined with proliferative vitreoretinopathy(PVR),retinal detachment,operation time and intraoperative combined therapy.In the retinal detachment group the incidence of posperative retinal detachment in patients of PVR was higher than that in the non-retinal detachment group(P=0.002).The difference of preoperative incidence of retinal detachment(P=0.032)and later operation time(P<0.001)were statistically significant.The proportion of intraoperative scleral cryotherapy and retinotomy in the retinal detachment group(P=0.020,0.000)was higher than that in the non-retinal detachment group during the operation.Conclusion PVR,preoperative retinal detachment,delayed surgery and over-operation during surgery are the main factors of retinal detachment after open ocular trauma surgery.