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目的:对比观察孔源性视网膜脱离(RRD)行玻璃体切割手术(PPV)联合惰性气体填充治疗后不同体位的疗效。方法:回顾性临床研究。2019年10月至2021年9月于青岛眼科医院检查确诊并接受PPV联合惰性气体填充治疗的RRD患者192例192只眼纳入研究。患眼均行最佳矫正视力(BCVA)、眼压、超广角眼底照相、光相干断层扫描、B型超声等检查。BCVA检查采用标准对数视力表进行,统计时换算为最小分辨角对数(logMAR)视力。根据手术后体位要求将患眼分为面向下体位组和可调节体位组,分别为97例97只眼和95例95只眼。两组患者年龄(n Z=0.804)、病程(n Z=-0.490)、眼别(n χ2=0.175)、logMAR BCVA(n Z=-0.895)、眼压(n Z=0.178)、晶状体状态(n χ2=1.090)、脱离时钟位数(n Ζ=0.301)和累及黄斑(n χ2=0.219)、裂孔数量(n Z=-1.051)和下方裂孔例数(n χ2=0.619)比较,差异均无统计学意义(n P>0.05);性别构成比比较,差异有统计学意义(n χ2=5.341,n P3个月。观察患眼一次手术视网膜复位率、BCVA提高情况和并发症发生率。组间连续变量比较行独立样本Mann-Whitney检验;分类变量比较行n χ2检验。n 结果:面向下体位组、可调节体位组患眼中一次手术视网膜复位分别为92(94.8%,92/97)、89(93.7%,89/95)只眼;logMAR BCVA分别为0.45±0.34、0.41±0.21。两组患眼间一次手术视网膜复位率(n χ2=0.120,n P=0.729)、logMAR BCVA(n Z=-0.815,n P=0.416)比较,差异均无统计学意义。手术后,面向下体位组、可调节体位组发生眼压升高分别为11(11.3%,11/97)、5(5.3%,5/95)只眼;继发性黄斑前膜分别为2(2.1%,2/97)、3(3.2%,3/95)只眼。两组患眼手术后眼压升高、继发黄斑前膜发生率比较,差异均无统计学意义(n χ2=2.320、0.227,n P=0.128、0.634)。n 结论:RRD行PPV联合惰性气体填充手术后采取可调节体位安全、有效,与面向下体位疗效相当。“,”Objective:To compare and observe the curative effect of different body positions after pars plana vitrectomy (PPV) combined with inert gas filling for rhegmatogenous retinal detachment (RRD).Methods:A retrospective clinical study. From October 2019 to September 2021, 192 eyes of 192 RRD patients who were diagnosed and received PPV combined with inert gas filling in Qingdao Eye Hospital of Shandong First Medical University were included in the study. Best corrected visual acuity (BCVA), intraocular pressure, ultra-wide-angle fundus photography, optical coherence tomography, and B-mode ultrasonography were performed in all affected eyes. The BCVA examination was performed using a standard logarithmic visual acuity chart, which was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. According to the post-operative position requirements, the affected eyes were divided into the face-down positioning group and the adjustable positioning group, with 97 eyes in 97 patients and 95 eyes in 95 patients, respectively. Age (n Z=0.804), course of disease (n Z=-0.490), eye type (n χ2=0.175), logMAR BCVA(n Z=-0.895), intraocular pressure (n Z=0.178), lens status (n χ2=1.090), number of detached clocks (n Z=0.301) and macular involvement (n χ2=0.219), number of holes (n Z=-1.051) and number of lower holes (n χ2=0.619) were compared, there was no significant difference (n P>0.05). The gender composition ratio was compared, and the difference was statistically significant (n χ2=5.341, n P<0.05). The follow-up time after surgery was more than 3 months. The retinal reattachment rate in one operation, the improvement of BCVA and the incidence of complications were observed. The independent sample Mann-Whitney test was used for the comparison of continuous variables between groups; then χ2 test was used for the comparison of categorical variables.n Results:In the face-down positioning group and the adjustable positioning group, retinal reattachment in one operation was performed in 92 (94.8%, 92/97) and 89 (93.7%, 89/95) eyes, respectively; logMAR BCVA was 0.45±0.34, 0.41±0.21. There was no significant difference in the retinal reattachment rate in one operation (n χ2=0.120, n P=0.729) and logMAR BCVA (n Z=-0.815, n P=0.416) between the two groups. After surgery, the intraocular pressure increased in 11 (11.3%, 11/97) and 5 (5.3%, 5/95) eyes in the face-down positioning group and the adjustable positioning group, respectively; the secondary epimacular membrane was 2 (2.1%, 2/97), 3 (3.2%, 3/95) eyes. There was no significant difference in the incidence of elevated intraocular pressure and secondary epimacular membrane between the two groups after surgery (n χ2=2.320, 0.227; n P=0.128, 0.634).n Conclusion:It is safe and effective to adopt adjustable positioning after PPV combined with inert gas filling for RRD, which is equivalent to the effect of face-down positioning.