| ObjectiveClinical comparative study, comparing the combined proliferative vitreoretinopa-thy (proliferative vitreoretinopathy, PVR) the complexity of traumatic retinal detach-ment (retinal detachment, RD) and patients with non-traumatic rhegmatogenous RD after vitrectomy (vitreoretinal surgical, VRS) using vision to improve the situation, retinal reattachment and postoperative complications, and explore the impact of trauma on the VRS RD treatment of visual acuity. MethodsA retrospective randomized control study between June2007to March2013in the Tianjin Eye Hospital, diagnosed by clinical complexity and RD lines VRS treatment of patients met the study inclusion criteria, a total of102cases of102eyes. Divided according to whether a history of trauma and non-trauma group trauma group. Blunt trauma group had a history of trauma, non-trauma patient group were rhegmatogenous RD. Two groups of patients by indirect inspection mirrors and B-mode ultrasound examination diagnosed after VRS treatment, follow-up of6to26months, average10.8months. Before comparing trauma surgery group and non-traumatic set of for age, sex, eye RD with giant holes, macular RD, choroidal detachment, VH situation; surgery were compared using heavy water and retinal incision situation. before comparing surgery and after surgery a month, three months, six months BCVA (best corrected visual acuity, BCVA) changes, comparison of postoperative improvement of visual acuity, anatomic conditions and the occurrence of postoperative complications. All data applications SPSS17.0statistical software for statistical analysis, measurement data were expressed as mean±standard deviation (x±s) that the normality test and homogeneity of variance test, the number of independent samples were compared using the t test between, count data line X2test, P<0.05was considered statistically significant. Results1.Preoperative visual acuity was significant difference (P<0.05), preoperative visual acuity before the trauma group was significantly worse than non-trauma group. Improve postoperative visual acuity was no significant difference (P>0.05), but within each group compared with the preoperative visual acuity improved significantly (P<0.05)2.Preoperative eye condition contrast, there was a significant difference (P<0.05) in the VH, choroidal detachment aspects. Between the two groups in the intraoperative use of heavy water are no significant differences (P>0.05), retinal whether there were significant differences in incision (P<0.05).3.Comparison of postoperative complications between the two groups, postoperative ocular hypertension,RD relapse, VH, complicated cataract, postoperative hypotony was no significant difference (P>0.05). Conclusions1.VRS is an effective means of treating complex traumatic and non-traumatic RD, which can effectively make detached retina reset so that patients get visual acuity improved significantly.2.Before trauma complicated eye surgery group, VH, choroidal detachment was significantly higher than non-trauma group, But the two groups by improving VRS no significant difference in visual acuity.3.Patients with traumatic RD VRS intraoperative retinal incision in the proportion of large, retinal incision, huge hole, VH can promote the occurrence and progress of PVR, increasing the difficulty of surgery, postoperative visual acuity improved.4.Traumatic and non-traumatic RD secondary glaucoma can occur after surgery, anterior chamber silicone oil, low intraocular pressure, and its incidence is no significant correlation between trauma.5.RD patients with traumatic and non-traumatic, whether in the VRS after silicone oil removal can make RD relapse, and whether the trauma with no obvious correlation, the main reason is the progress of RD recurrence of PVR, epiretinal membranes proliferation of new breaks and improper surgical operation... |
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