20G玻璃体切除术后视网膜脱离相关因素分析

目的探讨20G玻璃体切除术后视网膜脱离的相关因素。方法回顾性分析2010年7月至2013年1月20G玻璃体切除手术后发生视网膜脱离的31例（31只眼）。男17例占61％，女14例占39％；年龄20～70岁，平均年龄47-38岁；玻璃体切除术后发生视网膜脱离时间7～360d，平均（115．16±0．14）d；发生视网膜脱离后再次行玻璃体切除复位视网膜，眼内填充C3F8或硅油。结果玻璃体切除术后发生视网膜脱离的原因中：增生性玻璃体视网膜病变（PVR）16只眼（51．6％），原裂孔未封闭11只眼（35．5％）、新裂孔10只眼（32．3％）、玻璃体嵌顿3只眼（9．7％）。结论20G玻璃体切除术后发生视网膜脱离原因主要是前部PVR，与术中玻璃体、视网膜的正确处理、玻切机负压的设置、眼内填充物的选择有关。

Cause analysis of retinal detachment after 20G vitrectomy

OBJECTIVE To investigate the main cause of recurrent retinal detachment after 20G vitrectomy. METHODS Seventeen male （61%） and 14 （39） female recurrent cases aged from 20-70 with an average age of 47.38 were retrospectively analyzed. The recurrent time was from 7days to 12 months after vitrectomy. The surgeries with C3F8 tamponade or with silicone oil injection were selected after the recurrence. RESULTS The main causes of recurrent retinal detachment after 20G vitrectomy included 16 （51.6% ） eyes due to anterior PVR, 10 （32.3%） eyes due to new retinal holes, 11 （35.5%） eyes due to original holes reopened, 3 （9.7%） eyes due to vitreous temponade in the sclera incision. CONCLUSIONS The main causes of recurrent retina detachment after 20G vitrectomy was anterior PVR that was associated with negative pressure setting, tamponade selection and the technique of the vitrectomy.