玻璃体切除联合眼内填充治疗复杂视网膜脱离

目的　探讨复杂性视网膜脱离应用玻璃体切除联合眼内填充手术的效果及并发症的发生情况。方法　对2 9例伴有眼球破裂伤、眼内炎、玻璃体积血、白内障、PVR或糖尿病性视网膜病变等的复杂性视网膜脱离进行玻璃体视网膜手术的连续病例临床资料进行回顾性分析。结果　玻璃体切除联合玻璃体腔注气术12眼,1次手术视网膜复位8眼(66.67%) ;玻璃体切除联合玻璃体腔内硅油填充术2 0眼(包括注气失败的3眼) ,1次手术完全复位13眼(65 .0 0 %)。统计学检验两组1次手术视网膜复位率的差异无显著意义。术后视力较术前提高者2 1眼(72 .41%)。常见的并发症有复发性视网膜脱离、并发性白内障及继发性青光眼等。结论　玻璃体切除联合眼内填充能有效地治疗复杂性视网膜脱离,PVR仍然是术后视网膜脱离复发的主要因素。

Evaluation of vitrectomy combined with tamponade on complex retinal detachment

Objective To assess the effectiveness of vitrectomy combined with tamponade on complex retinal detachment and to analyse the incidence of complications. Methods A retrospective analysis of medical records of 29 cases of complex retinal detachment underwent vitrectomy with tamponade was performed. Results 12 eyes underwent vitrectomy with inert-gas tamponade, 8(67.67%) eyes achieved retinal reattachment primarily. 20 eyes ( including 3 eyes failed in inert-gas tamponing) underwent vitrectomy with silicon-oil tamponade, 13(65.00%)eyes achieved retinal reattachment primarily. The comparison between two groups has no significant difference. 21 eyes(72.41%) obtained higher visual acuity post-operatively. The main complications were recurrent retinal detachment, complicated cataract, secondary glaucoma and et al. Conclusion Vitrectomy combined with tamponade is a useful procedure for complex retinal detachment. PVR is still the major cause of recurrent retinal detachment post-operatively.