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The clinical analysis for secondary vitreous surgery

Objective To investigate the causes of failure of the primary vitrectomy,sum up the experience for secondary vitreous surgery and improve the success rate of primary vitrectomy for complicated retinal detachment． Methods The records of a consecutive series of 60 patients(65 eyes)that underwent secondary vitreous surgery between 1997 to 1998 were retrospectively reviewed.The age of patient ranged from 9 to 63 years(mean 36),and the followup period ranged from 3 to 18 months(mean 10.5 months). Results The main causes of failure of the primary vitrectomy were postoperative recurrence of proliferative vitreoretinopathy(PVR),unwell closed retinal breaks,and intra-and postoperative complications.In 46 of 65 eyes the retina was reattached after secondary vitreous surgery(70．1%)．Postoperatively,31 eyes (47.7%) had a visual acuity(VA)improved,16 eyes(24.6%)had a VA unchanged,and 18eyes(27.7%)had a VA reduced．Fifteen eyes(23.1%)had a VA of ge;0.05 and the best VA was 0.4．Thirty-nine eyes were followed-up from 3 to 18　months(mean 10.5)．In 35 of 39 eyes,the retina was reattached(89.7%),26 eyes(40%)had a VA of ge;0.05,and 7 eyes(10.7%)were hypotonic. Conclusions The keys to the success of secondary vitreous surgery are to restore the mobility for retina by eliminating the PVR completely,and avoid intraoperative complicattions by choosing the appropriate closure procedure for retinal breaks and the suitable intraocular tamponades. (Chin J Ocul Fundus Dis,20000,16:24-26)