孔源性视网膜脱离合并脉络脱离的玻璃体视网膜手术

目的：评价孔源性视网膜脱离合并脉络膜脱离的玻璃体视网膜手术（vitreoretinal surgery,VR手术）效果及失败原因。 方法：回顾性地分析61例（61眼）VR手术，全部眼有脉络膜脱离和增殖性玻璃体视网膜病变（prolirerative vitreoretinopathy PVR）。采用玻璃体切割及视网膜前膜剥除，气液交换、眼内惰性气体或硅油填充。 结果：近期（出院时）有效40眼（65.57%），用惰性气体的35眼中有效26眼（74.3%）.14例患者追踪3个月以上，平均追踪9.5个月， 有效10眼。影响手术的主要因素为脉络膜脱离范围、手术次数、气体填充及皮质激素使用时间，手术失败的主要原因可能与严重的PVR、前部PVR及巨大裂孔有关。 结论：采用VR手术可提高孔源性视网膜脱离合并脉络膜脱离的手术成功率。 （中华眼底病杂志，1996，12：16-19)

VITREORETINAL SURGERY FOR RHEGMATOGENOUS RETINAL DETACHMENT ASSOCIATED WITH CHOROIDAL DETACHMENT

OBJECTIVE:To evaluate the effect and causes of failure of vitreoretinal(VR)surgery in rhegmatogenous retinal detachments associated with choroidal detachment. METHOD:Reviewing the operative effects of the vitreoretinal surgeries in 61patients(61 eyes)with rhegmatogenous retinal detachment associated with choroidal detachment and PVR in this hospital.Vitrectomy,peeling of preretinal membranes,fluid/air echange and inert gas,silicone oil tamponade were used in thesepatients according to need. RESULTS:On discharge from the hospital,the postoperative effect obtained in 40 case(65.57%),and out of 35 eyes receiving the inert gas tamponade 26(74.3%) got effective pesults.Fourteen cases were followed up for 3 months(averge 9.5 months)and 10(7.4%）of themrevealed stable.The factors of influencing VRsurgery seemed to be the range of choroidal detachments,numbers of opreative times,the inert gas tamponede and the time of corticosteroid application.The causes of failure of opreation might relate to severe and antrior PVR,and giant tears. CONCLUSIONS:The VR surgery was thought to be profitable in treating rhegmatogenous retinal detachment associated with choroidal detachment and PVR. （Chin J Ocul Fundus Dis,1996,12: 16-19)