复杂性孔源性视网膜脱离的玻璃体视网膜手术失败原因初步探讨

目的探讨复杂性孔源性视网膜脱离的玻璃体视网膜手术失败原因。方法对４７７例（４７９只眼）复杂性孔源性视网膜脱离采用玻璃体视网膜手术（ｖｉｔｒｅｏｒｅｔｉｎａｌｓｕｒｇｅｒｙ,ＶＲ术）,即玻璃体切除、膜剥离、气液交换、惰性气体（ＳＦ６,Ｃ３Ｆ８）及硅油眼内填充。结果近期有效者３４７例（３４９只眼,７２．９％）,失败者１３０例（１３０只眼,２７．１％）。结论多因素逐步回归分析显示影响ＶＲ术近期效果的显著因素为眼内填充硅油、巨大裂孔、眼内填充ＳＦ６、医源性裂孔、前部增殖性玻璃体视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｖｉｔｒｅｏｒｅｔｉｎｏｐａｔｈｙ,ＰＶＲ）、严重视网膜下增殖、ＰＶＲ、眼内填充Ｃ３Ｆ８、手术频次及脉络膜脱离

A preliminary investigation on causes of failure of vitreoretinal surgery for complicated rhegmatogenic retinal detachments

Objective To evaluate the failure causes of vitreoretinal surgery for complicated rhegmatogenic retinal detachment. Methods Vitreoretinal (VR) surgery was performed on 477 cases (479 eyes) with complicated rhegmatogenic retinal detachment, the operative procedures including vitrectomy, peeling of pre retinal membrane, fluid air exchange, inert gas (SF 6 or C 3F 8) or silicone tamponade. Results On discharge, the operation was effective in 349 eyes (72.87%) and failed in 130 (27.13%) eyes. Conclusion The multiple stepwise multivariate regression shows that the factors significantly influencing VR surgery are silicone tamponade, giant retinal tears, SF 6 tamponade, iatrogenic tear, anterior proliferative vitreoretinopathy (PVR), subretinal proliferation, PVR, C 3F 8 tamponade, operative frequency and choroidal detachments.