摘要
目的分析经玻璃体切除联合硅油填充治疗视网膜脱离的临床特征,探讨影响其复发的危险因素。方法回顾分析我院2014年8月至2016年12月收治的327例(329只眼)视网膜脱离患者的临床资料,分析其中术后复发视网膜脱离患者的临床特征,探讨影响视网膜再次复发的危险因素。结果 329眼经过玻璃体切除联合硅油填充治疗患者中37眼(11.2%)复发,其中出现新裂孔的占32.4%(12/37),原裂孔未愈合者占40.5%(15/37),裂孔合并PVR分级C级以上者占62.2%(23/37),未见明确裂孔又合并PVR C级16.2%(6/37)。其中患者高龄(大于65岁)、下方视网膜裂孔、增殖性玻璃体视网膜病变C级以上、高度近视是复发的危险因素,其OR值和95%CI分别为:4.18(2.06,8.49),4.57(2.22,9.40),2.90(1.45,5.80),2.40(1.14,5.03)。而术前裂孔大小、裂孔数量、中低度近视、手术方式(23G/25G+)的差异等对术后是否复发无明显影响(P>0.05)。结论下方视网膜裂孔、高龄、PVR分级C级、高度近视是视网膜脱离患者玻璃体切除手联合硅油填充治疗术后复发的主要影响因素,视网膜裂孔和PVR是起引起再次视网膜脱离的主要原因。
Objective Analyze the clinical feature and to find out the risk factors of recurrence retinal detachment with silicone Oil tamponade after vitrectomy.Methods The clinical data of 327(329 eyes)retinal detachment from patients treated in our hospital from August 2014 to December 2016 were reviewed.Analyze the clinical features of postoperative retinal detachment and to explore the risk factors for the recurrence of the retinal detachment.Results A total of 37 patients(11.2%)had recurrent retinal detachment,among them 12 cases(12/37)with new holes,15 cases(15/37)with unclosed holes,23 cases with more than PVRC and unclosed breaks,and 6 cases with only PVR.The advanced age(older than 65),inferior retinal holes,PVR(c-level)and high myopia were risk factors for recurrence.The OR value and 95%CI wre respectively 4.18(2.06,8.49),4.57(2.22,9.40),2.90(1.45,5.80),2.40(1.14,5.03).the difference between the preoperative hole size,the number of holes,the low degree of myopia and the surgical method(23G/25G+)had no obvious effect on postoperative recurrence(P>0.05).Conclusion patients who combined with inferior retinal holes,advanced age,PVRC level,and high myopia,The likelihood of recurrence will increase.Retinal prespliting and PVR was the main cause of retinal detachment again.
作者
张凌
陈彬
韩宇
ZHANG Ling;CHEN Bin;HAN Yu(The Ophthalmology of Leshan People's Hospital/Ophthalmology Center of Leshan,Leshan,Sichuan,614000)
出处
《中医眼耳鼻喉杂志》
2018年第1期24-26,共3页
Journal of Chinese Ophthalmology and Otorhinolaryngology
关键词
视网膜脱离
硅油填充
复发
玻璃体切除术
Retinal detachment
Silicone oil filling
Recurrent
Vitrectomy
