Analysis On The Effect Of Glucocorticoid Application Combined With Vitrectomy For Retinal Detachment Associated With Choroidal Detachment

Retinal detachment associated with choroidal detachment is a special type of thecomplexity of rhegmatogenous retinal detachment,and has the characteristics of acuteonset,rapid development and poor prognosis. The disease was particularly prevalent in theelderly,high myopia and aphakia.because this disease often combined with uveitis,intraocular hypotension, andproliferative vitreoretinopathy,the success rate was predominantly lower than the generalrhegmatogenous retinal detachment.Glucocorticoids can control the inflammation throughreducing uveitis response,promoting suprachoroidal space liquid absorption,reducing thechoroidal detachment,reducing choroidal vasopermeability. The cure rate depends on reasonable application ofglucocorticoid,and appropriate timing of surgery.Objective: To evaluate the effect of glucocorticoid application combined withvitrectomy for choroidal detachment associated with retinal detachment.Methods: Review and analysis the clinical datum of fifty-three eyes of fifty-threepatients of choroidal detachment associated with retinal detachment were cured in ourhospital from November,2008to December,2011.There are30eyes of male patients and23eyes of female patients.aged from23to86years old（54.72years old average）,including29right eyes and24left eyes.52eyes had different degree PVR including grade C₁～C₃32eyes,grade D₁～D₃21eyes. choroidal detachment was annular28eyes,spherical25eyes.All thepatients underwent vitrectomy,C3F8or oil tamponade.Among them,27eyes were used glucocorticoidbefore vitrectomy,another26eyes underwent vitrectomy directly,and combined withIntravitreal triamcinolone injection.There were in prone position after surgery at least3～4weeks,all patients were followed up for3～6months. Application SPSS19.0package forstatistical analysis,to P<0.05was considered statistically significant.Results: The cure rate of glucocorticoids application before the operation and IVTAcombined with vitrectomy is no obvious difference,and no obvious ocular and systemiccomplications took placeï¼›The rate of C₁～C₃PVR was90.6%,the rat of D₁～D₃PVR was 61.9%ï¼›The preoperative PVR become more severe if patients with longer course of disease.Conclusions:1. The cure rate of glucocorticoids application before the operation andIVTA combined with vitrectomy is no obvious difference,and no obvious ocular andsystemic complications took place.2. The severe of PVR before the operation if patientswith longer course of disease,and lead to the worse cure rate of the disease after thevitrectomy.3.Morphology of choroidal detachment is unrelated with the ratio of retinalrestoration.4.Intravitreal triamcinolone has high security,and shorten the waiting time beforesurgery.