The Treatment And Prognosis Of Patients Who Had Fail In The Sclera Buckling

Objective: to study the reason for failure of the sclerabuckling and how to choice the ways and the prognosis ofthe operation.Method: Retrospectie obserational in60cases (60eyes)of primary RRD patients, who had the first operation linesclera strap, but the failure. The second operation Choosedo sclera strap adjustment, sclera strap or vitrectomy.A group of30patients (30eyes) do sclera strap adjustedor strap. B group of30patients (30eyes) was performedVitrectomy. the closed observation and follow-up weretaken after operation more than6months according to theout-patient medical history. Observation and analyzeretinal repositioned, Visual function recovery andcomplications of surgery. Chi-square test analyze twogroups of operation method success rate The visual acuityincreased after the operation and the incidence ofcomplications. Wilcoxon signed rank test analyze the PVRlevel of patients before the first and the second surgery.The main Causes of operative failure In60eyes were failure to seal holes in28eyes; new or previouslyunidentified retinal break,24eyes。result: A group of30eyes through second surgery, thereare22eyes anatomical reattachment to the retina, thesurgery success rate was73.33%. Group B30eyes throughsecond surgery,24eyes anatomical reattachment to theretina, the surgery success rate was80%. With chi-squareanalysis (X2=0.373P=0.542>0.05), we can take forno statistically significant differences in two kinds ofoperation success rate. Statistics showed that PVR inSecond operation was significantly severe than that inprimary surgery（χ2=10.049，P=0.018,P<0.05）. Withchi-square analysis （χ2=0.800，P=0.371>0.05）we can takefor no statistically significant differences of visionafter two groups operations. With chi-square analysis thecomplications of surgery: High intraocular pressure (χ2=4.007, P=0.045), the difference between the two groupswas statistically significant (P <0.05), group Boccurrence this complications more than group A. Inspectcontent deformation (χ2=9.603, P=0.002), the differencebetween the two groups was statistically significant (P <0.05), group A occur this complications more than groupB.Conclusion: The main causes of sclera strap failure wasthe exist of retina leak; ways of operation and operativeprocedures are the important factor to the effect of asecond surgery, we should be according to the causes offailure of surgery, patients eyes condition, theadvantages and disadvantages of the surgery, at the sametime give the minimum surgical trauma surgery principleas the choice of the ways of surgeryes.If have the rightsurgery, a second surgery WaiLu surgery or choosevitrectomy, both the success rate no obvious difference;The Second surgery hand improper selection and improperoperation will may lead to failure again.