玻璃体视网膜显微手术中医源性视网膜裂孔

目的：探讨玻璃体视网膜显徽手术中发生医源性视网膜裂孔的原因和处理措施． 方法：回顾性分析本院1994年7月至1996年3月玻璃体视网膜显微手术中发生的医源性视网膜裂孔24眼(40个裂孔)的原因，位置和术中术后的处理情况。 结果：24只眼中增殖性玻璃体视网膜病变(proliferative vitreoretinopathy，PVR)16只眼，外伤性PVR 5只眼，牵拉性视网膜脱离3只眼。对新裂孔的处理采用巩膜冷凝、硅胶填压、眼内电凝、眼内填充和术后激光光凝．下方和手术嵴后医源性视网膜裂孔分别占70%和92%．平均随访5个月，视网膜完全复位和黄斑复位17只眼，视力改善19只眼，均在0.02以上．结论：医源性视网膜裂孔是一种严重的并发症，应在术中、术后采取措施促使其封闭． （中华眼底病杂志，1997，13：19-21）

IATROGENIC RETINAL BREAKS IN MICRO-VITREORETINAL SURGERY

PURPOSE:To investigate the cause and treatment of iatrogenic retinal breaks(IRB)in microvitreoretinal surgery.METHODS:The causes and treatments of 40 iatrogenic retinal breaks of 24 cases in micro vitreoretinal surgery from July1994 to March 1996 in our department were analyzed retrospectively.RESULTS:40 IRB were found in 24 eyes,among them there were 16 eyes of proliferative vitreoretinopathy(PVR),5 eyes of taumatic PVR and 3 eyes of tractional retinal detachment.The treatments of IRB included scleral cryotherapy,silicone band buckling,endodiathermy,intraocular tamponade and postoperative argon laser.The IRB of inferior retina and posterior to scleral buckling acounded for 70% and 92%respectively.The total retinal and macular attachment were 17 eyes and the visual acuity of 19 eyes improved to 0.02 or better during the mean follow up periods of 5 months.CONCLUSION:The IRB is a severe complication in micro vitrecretinal surgery and has to be obliterated either intraoperatively or postoperatively.