沈孝军，彭　超，王　琛



玻璃体切除术后视网膜脱离的临床观察

沈孝军，彭超，王琛

Department of Ophthalmology, Jiangmen Central Hospital, the Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen 529030, Guangdong Province, China

Correspondence to:Xiao-Jun Shen. Department of Ophthalmology, Jiangmen Central Hospital, the Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen 529030, Guangdong Province, China. ophsums@sina.com

Received：2016-05-04Accepted：2016-07-13

•AIM:To investigate the causes and characteristics of retinal detachment after vitrectomy.

•METHODS: Retrospective analysis of patients in our hospital in recent 4a who underwent primary, standard, three-port pars plana vitrectomy(PPV). Retinal detachment occurred in 24 eyes(23 cases), 24-67 years old, average 49.0±12.0 years old. There were male in 17 cases, female in 6 cases, 6 right eyes, 18 left eyes.

•RESULTS: Eighteen (75%) eyes without any symptoms were found during a routine check, 6 eyes (25%) with decreased visual acuity or in front of shadow. It took 1-223d from PPV to retinal detachment, average 40.7±54.2d, of which retinal detachment occurred in 10 (42%) eyes within 1wk, 14 (58%) eyes within 1mo. The direct cause of retinal detachment was new retinal break (a total of 27 holes) in 19 eyes, proliferative vitreoretinopathy (PVR) in 4 eyes, 1 eyes with primary hole not closed. All retinal detachment were ultimately completely reset.

•CONCLUSION: The occurrence of new retinal breaks is the main cause of retinal detachment after vitrectomy, attention should be paid to the early postoperative peripheral retinal examination; after a timely surgery, the retina can be reset.

Citation:Shen XJ, Peng C, Wang C.Clinical characteristics of retinal detachment after vitrectomy.GuojiYankeZazhi(IntEyeSci) 2016;16(8):1576-1578

摘要

目的:探讨玻璃体切除术后视网膜脱离的原因、特点。

方法:回顾性分析在我院近4a行20G标准三通道玻璃体切除手术的患者病例资料，术后发生视网膜脱离的病例纳入研究对象，分析视网膜脱离的特点及处理。术后发生视网膜脱离共23例24眼。年龄24～67(平均49.0±12.0)岁。男17例18眼，女6例6眼。右眼6眼，左眼18眼。

结果:视网膜脱离的24眼中，18眼(75%)无任何症状，为常规检查时所发现；6眼(25%)为视力下降或眼前黑影遮挡就诊时发现。视网膜脱离距离玻璃体切除术后的时间1～223(平均40.7±54.2)d，其中10眼(42%)发生于1wk内，14眼(58%)发生于1mo内。视网膜脱离的直接原因中：新发视网膜裂孔19眼，共27个裂孔；增殖性玻璃体视网膜病变(PVR)4眼；原裂孔未封闭1眼。所有视网膜脱离最终均完全复位。

结论：视网膜新裂孔的发生是导致玻璃体切除术后视网膜脱离的最主要原因，应重视术后早期周边视网膜的检查；经过及时的再次手术，视网膜均可得以复位。

关键词：玻璃体切除术；视网膜脱离；视网膜裂孔；增殖性玻璃体视网膜病变

引用：沈孝军，彭超，王琛.玻璃体切除术后视网膜脱离的临床观察.国际眼科杂志2016;16(8):1576-1578

0引言

1970年Machemer发明玻璃体注吸切除器，逐步改进成为玻璃体切割机，开创了现代玻璃体手术。随着手术技巧的提高及手术设备的改进，玻璃体视网膜手术有了极大的发展，手术适应证也越来越广，从此,为许多过去无法治疗的眼病开辟了新的治疗途径。……