【摘要】 目的:评估27G经睫状体平坦部玻璃体切割术（PPV）联合过滤空气填充治疗孔源性视网膜脱离（RRD）的疗效和安全性。方法:收集RRD患者患眼30例30眼,裂孔均位于上方且裂孔偏后,裂孔处有血管骑跨或多个裂孔不在同一圆周,不适合行外路手术者,排除复发性RRD、增殖性玻璃体视网膜病变（PVR）C₂及以上、巨大视网膜裂孔者,行27G PPV联合过滤空气填充。随访1周、1月、3月、6月,记录最佳矫正视力（BCVA）和眼压,观察视网膜是否复位、玻璃体腔气体吸收情况以及手术相关并发症的发生情况。结果:术眼的术前平均BCVA（Log MAR）为1.10±0.40,术后1周为0.70±0.92,术后1月为0.60±0.31,术后3月为0.55±0.30,术后6月为0.6±0.30,手术前后术眼BCVA总体比较差异有统计学意义（F=63.12,P<0.01）,术后1周、1月、3月、6月BCVA均高于术前,差异均有统计学意义（均P<0.05）。术眼的术前平均眼压为（11.2±3.6）mmHg,术后1周为（20.3±2.3）mmHg,术后1月为（17.3±2.3）mmHg,术后3月为（15.6±2.4）mmHg,术后6月为（16.4±3.2）mmHg,手术前后术眼眼压总体比较差异有统计学意义（F=15.82,P<0.01）,术后1周、1月、3月、6月眼压均高于术前,差异均有统计学意义（均P<0.05）。术眼术后一次性手术视网膜解剖复位者30眼,复位率达到100%,气体完全吸收平均时间为（10.7±3.6）d。在随访期间,有1眼在术后3月出现复发性视网膜脱离。2眼术后3月发生并发性白内障,其余未出现其他并发症。结论:27G PPV联合过滤空气填充治疗RRD安全且有效。更多还原

【Abstract】 Objective:To evaluate the effect and safety of 27-gauge pars plana vitrectomy(PPV) in repairing rhegmatogenous retinal detachment(RRD)with filtered air tamponade. Methods:Thirty eyes with RRD caused by superior retinal breaks were included. Exclusion criteria were secondary RRD,proliferative vitreoretinopathy of grade C2 or greater, and giant retinal tears. A 27-gauge PPV with intraocular filtered air tamponade was carried out. Patients were followed up at 1 week, 1, 3 and 6 months.Outcome measures included best corrected visual acuity(BCVA),intraocular pressure(IOP), retinal attachment rate,air bubble resolution, and complications. Results:The mean BCVA(Log MAR) was 1.10±0.40,0.70±0.92,0.60±0.31,0.55±0.30 and 0.60±0.30 before surgery,1 week,1 months,3 months and 6 months after surgery respectively.There was a significant difference among them(F=63.12,P<0.01),and the BCVA at 1 week,1 months, 3 months and 6 months after surgery was evidently improved in comparison with before surgery(both at P<0.05).The mean IOP was(11.2±3.6),(20.3±2.3),(17.3±2.3),(15.6±2.4) and(16.4±3.2)mmHg before surgery,1 week,1 months,3 months and 6 months after surgery respectively.There was a significant difference among them(F=15.82,P<0.01),and the IOP at 1 week,1 months, 3 months and 6 months after surgery was evidently higher than that before surgery(both at P<0.05). The reattachment rate by a single procedure was 100%.The complete resolution of the air bubble took on average(10.7±3.6) days. Only one eye presented a recurrent RD at 3 months after surgery.Two eyes developed nuclear cataracts at 3 months after surgery.No other postoperative complication was reported. Conclusions:27-gauge vitrectomy and filtered air tamponade for RRD is an effective and safe approach.更多还原