孔源性视网膜脱离伴增生性玻璃体视网膜病变视网膜切开术后预后因素分析  

Multifactor analysis of prognosis in patients with rhegmatogenous retinal detachment with proliferative vitreoretinopathy after retinotomy

作　　者：于亚杰[1] 郑鹏飞[1] 陈惠茹[1] 

机构地区：[1]首都医科大学附属北京同仁医院眼科中心,100730

出　　处：《眼科》2008年第4期262-264,共3页Ophthalmology in China

摘　　要：目的研究孔源性视网膜脱离伴增生性玻璃体视网膜病变(PYR)患者视网膜切开术后视网膜解剖和功能结果与预计影响因素之间的关系。设计回顾性病例系列。研究对象99例(102眼)孔源性视网膜脱离伴PVR行视网膜切开术者。方法采用多元Logistic回归分析法分析术前视力、术前手术次数、视网膜脱离范围、PVR病变程度、硅油填充时间、视网膜切开范围、硅油取出与否与术后视力、术后视网膜复位情况及低眼压的相关性。主要指标多种因素的OR值。结果术前视力、术前手术次数、硅油填充时间、硅油取出与否、视网膜切开范围对术后视力的影响有统计学意义(OR:1.13～5.33,P均<0.05);术前手术次数、硅油取出与否对术后视网膜复位的影响有统计学意义(OR:2.55～3.79,P均<0.05);硅油取出与否对术后低眼压的影响有统计学意义(OR:0.26,P=0.001)。结论适时地硅油取出、小范围的视网膜切开、较少的术前操作和较好的术前视力是孔源性视网膜脱离伴PVR患者视网膜切开术后获得较好视网膜解剖和功能结果的影响因素,建议应在PVR进展早期行视网膜切开手术。Objective To study the association of retinal anatomy and function after retinotomy with multi-parameters in patients with rhegmatogenous retinal detachment （RRD） and proliferative vitreoretinopathy （PVR）. Design A retrospective case series. Partici- pants 99 patients （102 eyes） with RRD and PVR after retinotomy. Methods Logistic regression analysis was used for evaluating the association of the preoperative visual acuity and frequency of operations before retinotomy, range of retinal detachment, the extent of PVR, time of silicon oil tamponade, the range of retinotomy and the take-off of silicon oil with the postoperative visual acuity, the reattachment of retina, and intraocular hypotension. Main Outcome Measurements Odds ratio of multi-factors. Results Postoperative visual acuity had significant correlation with the preoperative visual acuity, frequency of operation before retinotomy, the range of retinotomy, and the tamponade and take-off of silicon oil （OR：1.13-5.33, all P 〈0.05）. The postoperative reattachment of retina had significant cor- relation with frequency of operation before retinotomy and the take-off of silicon oil （OR： 2.55-3.79, all P 〈0.05）. The postoperative intraocular hypotension had significant correlation with the take-off of silicon oil （OR： 0.26, P=0.001）. Conclusions The influence factors of better retinal function in patients with rhegmatogenous retinal detachment with PVR after retinotomy are appropriate silicon oil tamponade and take-off, limited local retinotomy, few surgical times before retinotomy and better preoperative visual acuity. We suggest retinotomy should be early performed in early stage of PVR advance with RRD.

关 键 词：视网膜脱离/外科学 视网膜切开术 增生性玻璃体视网膜病变 

分 类 号：R779.6[医药卫生—眼科]