目的 :探讨显微镜下视网膜脱离手术的可能性及结果。方法 :对 2 5例 2 5只裂孔性视网膜脱离眼 ,先预置硅胶块和 /或环扎带 ,然后 ,在手术显微镜监控下经巩膜电凝排出视网膜下液、视网膜冷凝 ,最后顶起硅胶填压块检查裂孔位置是否正确 ,眼内注入过滤空气或 C3F8气体。定期观察术后视力、眼内反应和视网膜复位情况。结果 :视网膜完全复位 2 4只眼 ,再次外路手术后视网膜复位 1只眼。视力提高 2 1只眼 ,不变 1只眼 ,下降 2只眼 ,最好矫正视力在 0 .3以上 14只眼。除视网膜下液引起视网膜下出血2例和穿透视网膜 1例外 ,其它病例排液顺利。所有病例显微镜直视下巩膜冷凝反应清晰可见 ,轻度屈光间质浑浊并不影响观察冷凝反应和裂孔定位。结论 :显微镜下视网膜脱离手术具有简单、方便、直视、可靠和效果良好等优点 Objective: To investigate the possibility of retinal detachment under microscope and the result. Methods: Twenty-five patients with 25 eyes with split-type retinal detachment were pre-prepared with silicone blocks and / or ligaments. After scleral coagulation under the control of a surgical microscope, the retina was excreted and the retina was allowed to condense. Finally, silica gel Fill block check the location of the hole is correct, intraocular injection of filtered air or C3F8 gas. Regular observation of postoperative visual acuity, intraocular reactions and retinal reattachment. Results: The retina was completely resected in 24 eyes, and the retina was repositioned in one eye after external surgery. Visual acuity improved 21 eyes, unchanged in 1 eye, down 2 eyes, best corrected visual acuity in 0.3 above 14 eyes. In addition to subretinal fluid caused by subretinal hemorrhage in 2 cases and 1 case of penetrating the retina, the other cases drained smoothly. The scleral condensation reaction was clearly seen in all cases under microscope. Mild turbid refraction did not affect the observation of condensation reaction and pore orientation. Conclusions: Microsurgery for retinal detachment has the advantages of simplicity, convenience, direct vision, reliability and good effect