光定位不准的视网膜脱离患者手术疗效分析

目的分析一组光定位不准的视网膜脱离施行玻璃体手术的疗效，评价术前光定位检查对判断视网膜脱离手术预后的价值。方法回顾分析光定位不准的复杂视网膜脱离43例（46只眼）手术随访资料。结果43例（46只眼）中，术前视力光感10只眼，手动24只眼，指数且〈0．02（1m指数）者12只眼。视网膜脱离范围仅限于黄斑部8只眼，1—2个象限12只眼，3—4个象限26只眼。光定位不准的方位数目与视网膜脱离范围相关。术后随访时间6个月以上，视网膜复位40只眼（86．9％）。46只眼中，10．9％最终视力≥0．3；41．3％视力〈0．3但≥0．05；43．5％仅有手动或指数视力；4．3％视力光感。术后视力改善30只眼（65．2％），不变15只眼（32．6％），下降1只眼（2．2％）。术后视力与术前光定位不准方位数目有关。结论光定位不准的复杂视网膜脱离经玻璃体手术仍然可以恢复一定的视力。术前光定位检查对视网膜脱离视力预后有一定参考价值。

Visual outcome of vitrectomy for complicated vitreoretinal diseases with faulty light projection

Objective To assess the visual outcome following vitrectomy for complicated retinal detachment with faulty light projection. Methods We performed vitreoretinal surgery on 46 eyes of complicated retinal detachment with faulty light projection. The patients were followed up for 6 - 16 months. Results Post-vitrectomy, 65.2% of eyes had improved vision. Resultant visual acuity was ≥0.3 in 10.9% of all eyes, 41.3% maintained functional vision, defined as worse but still ≥0.05 ; 43.5% maintained ambulatory vision, defined as worse but still count fingers （CF） or hand motion （ HM ） ; and 4.3% had poor visual outcome of LP. Post-operative vision was associated with the number of positions with faulty light projection. Conclusion Vitreoretinal surgery is valuable to the eyes of complicated retinal detachment with faulty light projection.