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目的 :探讨针对不同条件的巨大裂孔视网膜脱离如何采取更为有效的手术方案。方法 :回顾 2 0 0 0年 1月～ 2 0 0 1年 8月间我院手术治疗的巨大裂孔视网膜脱离 3 7眼 ,其中单纯型 6眼 ,复杂型 3 1眼 ,手术采用环扎加压和玻璃体手术。结果 :3 7眼手术后平均 6月总的视网膜解剖复位率为 81 1% ,单纯型 10 0 % ,复杂型 77 4% ,膜形成Ⅰ～Ⅱ级的复位率为96% ,Ⅲ级以上的复位率为 5 0 % ,术后视力改善不明显。结论 :首选完善的玻璃体手术治疗单纯型比环扎加压术更有效 :复杂型首选玻璃体手术 ;全氟碳液应选择病例使用 ;在眼内条件尚可的情况下 ,适宜首选全氟化碳气体填充 ;环扎加压术适合作为补充治疗方法使用 ;充分利用冷凝和激光封闭裂孔十分关键 ;严密细致的术后观察和补充治疗有决定性的作用 ;PVR是导致手术失败和复发的主要原因。
Objective: To explore how to take a more effective surgical approach to the treatment of giant hiatal retinal detachment under different conditions. Methods: Thirty-seven eyes of giant hiatal retinal detachment underwent surgery in our hospital from January 2000 to August 2001 were retrospectively reviewed. Among them, 6 were simple type and 31 were complicated type. Surgical operation was performed by cerclage And vitreous surgery. Results: The average rate of retinal reattachment was 81 1%, simple type 10 0%, complex type 77 4% in 3 7 eyes after operation, and the rate of reparation of grade Ⅰ ~ Ⅱ was 96% Reset rate was 50%, visual acuity improved not obvious. CONCLUSIONS: The preferred perioperative vitrectomy is more effective than cerclage surgery: the preferred type of complex vitreous surgery; the perfluorocarbon solution should be used in selected cases; and in the case of intraocular conditions, the preferred perfluorocarbon Gas filling; cerclage compression surgery is suitable for use as a supplementary treatment; make full use of condensation and laser-enclosed holes is critical; close and meticulous postoperative observation and supplementary treatment have a decisive role; PVR is the main reason leading to surgical failure and recurrence.