【摘要】 目的分析玻璃体切除术中医源性视网膜裂孔的发生情况。方法回顾性分析行20G标准三通道玻璃体切除手术的患者463例(482眼)的临床资料,分析医源性视网膜裂孔的发生率、部位等,并比较不同临床特征患者术中医源性视网膜裂孔的发生情况。结果共有44(9.1%)眼术中发生医源性视网膜裂孔,增殖性糖尿病视网膜病变者的发生率最高,为10.9%(28/257)。术前无玻璃体后脱离眼的医源性视网膜裂孔发生率为11.8%,高于术前有玻璃体后脱离眼的6.8%(P<0.05)。有晶体眼和无或人工晶体眼的医源性视网膜裂孔发生率分别为9.4%和5.6%,两组比较,差异无统计学意义(P>0.05)。结论增殖性糖尿病视网膜病变者玻璃体切除术中医源性视网膜裂孔的发生率最高,术前玻璃体未完全后脱离、术中制作玻璃体后脱离者更易出现医源性裂孔,晶状体状态和裂孔的发生无明显关系。更多还原

【Abstract】 Objective To analyze the incidence of iatrogenic retinal breaks during pars plana vitrectomy. Methods The clinical data of 463 patients( 482 eyes) undergoing primary standard 20 G three-port pars plana vitrectomy were retrospectively analyzed. The incidence and location of iatrogenic retinal breaks were analyzed. And the incidences of iatrogenic retinal breaks during the surgery were compared between the patients with different clinical characteristics. Results The iatrogenic retinal breaks occurred in 44 eyes( 9. 1%),and the incidence was the highest in proliferative diabetic retinopathy( 10. 9%,28 /257). The incidence of iatrogenic retinal breaks in the eyes without posterior vitreous detachment before surgery was 11. 8%,and was higher than that in the eyes with posterior vitreous detachment before surgery( 6. 8%,P < 0. 05). The incidence of iatrogenic retinal breaks in the phakic eyes and nonphakic / pseudophakic eyes were 9. 4%and 5. 6% respectively,but no statistical difference was observed between two groups( P > 0. 05). Conclusion Patients with proliferative diabetic retinopathy have the highest incidence of iatrogenic retinal breaks during pars plana vitrectomy. And the eyes without posterior vitreous detachment before surgery but obtaining posterior vitreous detachment during surgery are liable to iatrogenic retinal breaks. And the incidence of retinal breaks is not obviously related to the lens status.更多还原