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目的:评价孔源性视网膜脱离合并脉络膜脱离的玻璃体视网膜手术(vitreoretinal surg-ery,VR手术)效果及失败原因。方法:回顾性地分析61例(61眼)VR手术,全部眼有脉络膜脱离和增殖性玻璃体视网膜病变(prolirerative vitreoretinopathy PVR)。采用玻璃体切割及视网膜前膜剥除,气液交换、眼内惰性气体或硅油填充。结果:近期(出院时)有效40眼(65.57%),用惰性气体的35眼中有效26眼(74.3%)。14例患者追踪3个月以上,平均追踪9.5个月,有效10眼。影响手术的主要因素为脉络膜脱离范围、手术次数、气体填充及皮质激素使用时间,手术失败的主要原因可能与严重的PVR、前部PVR及巨大裂孔有关。结论:采用VR手术可提高孔源性视网膜脱离合并脉络膜脱离的手术成功率。
Objective: To evaluate the effect of vitreoretinal surg-ery (VR) surgery on rhegmatogenous retinal detachment associated with choroidal detachment and its causes. METHODS: Sixty-one (61 eyes) of VR surgeries were retrospectively analyzed. All eyes had choroidal detachment and proliferative vitreoretinopathy (PVR). Vitrectomy and retinal detachment, gas-liquid exchange, intra-eye inert gas or silicone oil filling. Results: 40 eyes (65.57%) were effective in the short term (at discharge) and 26 eyes (74.3%) in 35 eyes with inert gas. Fourteen patients were followed up for more than 3 months, with an average follow-up of 9.5 months and 10 eyes. The main factors affecting the operation of choroidal detachment range, the number of operations, gas filling and corticosteroid use time, the main reason for failure may be severe PVR PVR and the front of a huge hole. CONCLUSIONS: VR surgery can improve the surgical success rate of rhegmatogenous retinal detachment with choroidal detachment.