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目的 探讨巩膜环扎术在孔源性视网膜脱离 (rhegmatogenous retinal detachement,RRD)玻璃体手术中的应用价值。 方法 回顾分析 1995～ 1999年由我院 RRD计算机分析系统收录的 RRD行玻璃体手术者共 2 5 4例中有随访记录的 118例的临床资料。全部患者均为 1次玻璃体手术 ,按手术中是否进行巩膜环扎分为巩膜环扎组和非环扎组 ,分别分析各组增生性玻璃体视网膜病变 (proliferative vitreo-retinopathy,PVR)级别、裂孔位置、不同眼内填充物与视网膜解剖复位率的关系。 结果 118例患者手术后随访 1.5个月～ 3年 ,平均随访时间为 6 .5个月。视网膜复位 96例 ,占 81.4 % ,未复位 2 2例 ,占 18.6 %。视网膜复位者中巩膜环扎组视网膜复位 4 3例 ,占 4 4 .7% ,非环扎组视网膜复位 5 3例 ,占 5 5 .3%。巩膜环扎组与非环扎组 PVR不同级别 (C,D级 )、不同填充物以及 PVR C级不同部位视网膜裂孔 (裂孔位于赤道前、赤道区或赤道前后均有裂孔 )视网膜复位率比较其差异无显著性意义 (P>0 .0 5 )。而 PVR D级视网膜裂孔位于赤道后者巩膜环扎组与非环扎组比较 ,非环扎组视网膜复位率高于环扎组 ,其差别有显著性意义(P<0 .0 5 )。 结论 RRD玻璃体手术中巩膜环扎与否对视网膜脱离手术后视网膜复位率无明显影响
Objective To investigate the value of scleral cerclage surgery in rhegmatogenous retinal detachment (RRD) vitreous surgery. Methods The clinical data of 118 cases with RRD vitreous surgery who were enrolled in our hospital from 1995 to 1999 were analyzed retrospectively. All patients underwent vitrectomy. According to whether the scleral buckling was performed during the operation, the patients were divided into scleral cerclage group and non-cerclage group. The levels of proliferative vitreo-retinopathy (PVR) , The relationship between different intraocular filling and retinal anatomic reduction rate. Results A total of 118 patients were followed up for 1.5 months to 3 years after operation. The mean follow-up time was 6.5 months. Retinal reattachment in 96 cases, accounting for 81.4%, not reset in 22 cases, accounting for 18.6%. Retinal reattachment in the scleral cerclage group retinal reset 43 cases, accounting for 44.7%, non-cerclage retinal reset 53 cases, accounting for 53.3%. The retinal reattachment rates in different groups (C, D grade), different fillers and PVR C grade retinal breaks in the scleral cerclage group and non-cerclage group compared with those in the non-cerclage group (with pre-equatorial or equatorial or anterior or posterior equator) There was no significant difference (P> 0.05). The PVR D-level retinal breaks in the equatorial scleral cerclage group compared with the non-cerclage group, non-cerclage group retinal reattachment rate was higher than the cerclage group, the difference was significant (P <0.05). Conclusions There is no significant effect of the scleral cerclage ring in RRD vitreous surgery on retinal reattachment rate after retinal detachment surgery