视网膜脱离复位术后再手术分析  

Re-operation after Retinal Detachment Reduction

作　　者：陈建斌[1] 项楠[1] 张虹[1] 孙京华[1] 杨红[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,武汉430030

出　　处：《华中科技大学学报（医学版）》2006年第4期550-552,共3页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的探讨视网膜脱离手术失败或术后复发影响因素及其再手术治疗效果。方法以同期一次手术成功50例患眼作对照,回顾分析再次行视网膜脱离复位手术54例患眼视网膜脱离相关病情,并研究采用不同手术方式再次行视网膜复位的治疗效果。结果54例再次行视网膜脱离复位手术眼,发现原裂孔未封闭或再次裂开19只眼(36.1%),新裂孔或遗漏裂孔30只眼(55.6%)。大部分患眼伴有不同程度玻璃体视网膜增殖病变(PVR)。再次手术11只眼行玻璃体腔注气术,22只眼行巩膜扣带术,21只眼行玻璃体切除术,其成功率分别为72.7%、90.9%和85.7%。结论裂孔封闭不全是视网膜脱离复发或未能复位直接原因,PVR是形成新裂孔、影响裂孔闭合及视网膜复位的主要因素。视网膜脱离再次手术成功关键仍是可靠地封闭裂孔,应针对具体病情采取不同手术方式。Objective To explore the factors related to operation failure and postoperative recurrence of retinal detachment, and their re-operation effects. Methods A retrospective analysis of relative pathogenetic conditions of 54 cases who received reoperation of retinal detachment in contrast with 50 cases that underwent successful operation for one time was performed, and re-operation effects of retinal detachment reduction was studied by the different operation methods. Results Among the 54 cases who received re-operation, previous tears were not closed or torn again in 19 eyes （36.1 % ） and new breaks or missed holes were found in 30 eyes （55.6 % ）. Most cases were companied by various extent proliferative vitreoretinopathy （PVR）. Eleven, 22 and 21 cases subject to re-operation respectively received intravitreous pneumatic retinopexy, scleral buckling procedure and vitrectomy, and the successful rate was 72.7 %, 90.9% and 85.7 % respectively. Conclusion Incomplete closure of breaks is immediate cause of reduction failure and recurrence of retinal detachment, and PVR is main factor contributing to formation of new breaks, and influencing closure of breaks and reattachment of retina. Reliable closure of breaks is still successful key to retinal detachment re-operation.

关 键 词：视网膜脱离 再手术 

分 类 号：R774.12[医药卫生—眼科]