正视眼视网膜脱离的手术预后与玻璃体病变关系的分析

目的 研究正视眼视网膜脱离（ｒｅｔｉｎａｌ ｄｅｔａｃｈｍｅｎｔ,ＲＤ）患者的手术预后及其与玻璃体改变的关系。方法 回顾１９９６年月至１９９７年７月在我院行手术治疗的孔源性视网膜脱离患者１２６２例（１２４９只眼）,其中近视有ＲＤ组１０３１只眼,正视眼ＲＤ组２４３只眼,并研究增殖性玻璃体视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅ ｖｉｔｒｅｏｒｅｔｉｎｏｐａｔｈｙ,ＰＶＲ）的分级及玻璃体后脱离（ｐｏｓｔ

Relationship between the prognosis of retinal detachment in emmetropic eyes and vitreous changes

OBJECTIVE: To study the relationship between surgical prognosis of retinal detachment (RD) in emmetropic or myopic eyes and vitreous changes. METHODS: Postoperatively, 1,294 eyes of 1,262 patients with rhegmatogenous RD including 243 emmetropic and 1,031 myopic eyes were retrospectively studied. The affects of proliferative vitreoretinopathy (PVR), posterior vitreous detachment (PVD), vitreous liquefaction and concentration on the surgical prognosis were evaluated. RESULTS: The cure rate in emmetropic group (88.5%) was lower than that in myopic group (93.8%, P < 0.01). Also, the cure rate by initial surgery in emmetropic group (65.4%) was lower than that in myopic group (76.4%, P < 0.01). In addition, the occurrences of PVD (39.6%) and liquefaction (76.1%) in emmetropic group were lower than that in myopic group (51.7%, and 81.8% respectively, P < 0.05). However, focal vitreous concentration in emmetropic group (56.8%) was much higher than that in myopic group (19.6%, P < 0.01). CONCLUSIONS: The surgical prognosis of RD especially by initial operation is worse in emmetropic group than that in myopic group. The lower occurrences of PVD and liquefaction but higher occurrence of focal vitreous concentration in emmetropic eyes may have impact on the prognosis. It is possible that the vitreous characteristics in emmetropic eyes with RD have relationship to the occurrence and development of PVR that has the influence on the prognosis to some extent.