目的：随着玻璃体切除术的不断发展，特别是惰性气体和硅油在眼内的应用，玻璃体积血、眼内炎、增生性糖尿病性视网膜病变等严重玻璃体视网膜疾病都得到了有效的治疗。但是术后也伴随发生了一些并发症，严重影响了患者视力的恢复。本研究旨在观察玻璃体切除术后各种并发症的发生率和发病机制，为避免和减少并发症的发生提供临床参考。

方法：本研究选用本院200例玻璃体切除术的患者进行回顾性分析，手术由同一术者实施，酌情填充惰性气体或硅油。按玻璃体填充物将患者分为单纯玻璃体切除组、惰性气体填充组和硅油填充组； 按术后是否发生高眼压将患者分为正常眼压组和高眼压组； 按年龄将患者分为≥50岁组和<50岁组。分别观察玻璃体切除术后各组并发症的发生率、危险因素和处理方法。

结果：研究表明玻璃体切除术后的主要并发症包括眼压升高、继发性青光眼、角膜病变、并发性白内障、玻璃体出血、视网膜脱离、医源性视网膜裂孔、前房渗出膜、脉络膜和睫状体脱离等。根据本组数据统计分析，认为单纯玻璃体切除组、惰性气体填充组和硅油填充组发生各种术后并发症有明显差异。其中，惰性气体填充组和硅油填充组术后眼压升高和继发性青光眼的发生率明显高于单纯玻璃体切除组，尤其是惰性气体填充组术后高眼压的发生率更高。惰性气体填充组和硅油填充组术后并发角膜病变和并发性白内障的发生率明显高于单纯玻璃体切除组，而且与术后高眼压密切相关。玻璃体出血、医源性视网膜裂孔、视网膜脱离、前房渗出膜、脉络膜和睫状体脱离等并发症各分组之间无显著差异。

结论：玻璃体切除术是治疗严重玻璃体视网膜疾病的有效方法，术后大部分患者视力都得到了不同程度的提高。但是术后并发症严重影响了术后效果，如何提高手术技巧，避免减少和及时正确的处理术后并发症是玻璃体视网膜手术成功的关键，也是今后玻璃体切割术研究的重点，需要我们继续探索和研究。

AIM: With the advancement of pars plana vitrectomy, especially the intraocular application of inert gases and silicone oil, many serious vitreoretinal diseases, such as vitreous hemorrhage, endophthalmitis, proliferative diabetic retinopathy etc. have received effective treatment. But it is undeniable that there are many complications after vitrectomy that have seriously affected patients' vision recovery. The aim of this study is to observe the incidence and pathogenesis of various complications after vitrectomy to provide some clinical references to avoid and reduce the incidence of complications.

METHODS: This paper retrospectively analyzed records of 200 cases that underwent vitrectomy operated by the same surgeon. Inert gasesor silicone oil was filled accordingly. According to filling agent, patients were divided into simple vitrectomy group, inert-gas tamponade group and silicon-oil tamponade group; according to ocular hypertension onset, patients were divided into normal intraocular pressure group and ocular hypertension group; according to age, patients were divided into ≥50 group and <50 group. Relative analysis was made on the incidence, dangerous factors and management of complications in each group after vitrectomy.

RESULTS: According to the study, the major postoperative complications of vitrectomy were increase of introculr tension, secondary glaucoma, corneal diseases, complicated cataract, vitreous hemorrhage, retinal detachment, iatrogenic retinal hole, fibrin formation in anterior chamber, choroid and ciliary body detachment, and so on. According to statistical analysis of data of this group, it was believed that there were obvious differences among simple vitrectomy group, inert-gas tamponade group, silicon-oil tamponade group in postoperative complications. The postoperative incidence of increase of introculr tension and secondary glaucoma in inert-gas tamponade group and silicon-oil tamponade group were obviously higher than that in simple vitrectomy group. What's more, in inert-gas tamponade group, the postoperative incidence of ocular hypertension was much higher. The postoperative incidence of corneal complications and complicated cataract in inert-gas tamponade group and silicon-oil tamponade group were obviously higher than that in simple vitrectomy group and closely correlated with postoperative ocular hypertension. There were no distinct differences among every group in vitreous hemorrhage, iatrogenic retinal hole and retinal detachment, fibrin formation in anterior chamber, choroid and ciliary body detachment.

CONCLUSION:Vitrectomy is an important and effective treatment method for serious vitreoretinal diseases and most patients have obtained different visual improvement after the surgery. But postoperative complications seriously affect postoperative effect. The key to the success of vitreous retinal surgery in the future is that how to improve surgical techniques to avoid, reduce and timely dispose postoperative complications. It is also the emphasis of research of vitrectomy which deserves more exploration and research.