方法：回顾性分析2012-01/2014-06经过视力、眼压、裂隙灯、眼底及B超等检查诊断为玻璃体积血患者200例208眼，所有患者采用25G微创玻璃体切除术。比较术前、术后1wk，1、3、6mo最佳矫正视力。观察眼压、前房炎症反应、眼底情况等临床资料。

结果：术前视力光感16眼，手动82眼，指数49眼，0.01～0.09者38眼，0.1～0.2者23眼； 术后6mo视力手动1眼，指数2眼，0.01～0.09者31眼，0.1～0.2者29眼，0.2以上者145眼，术后所有患者视力稳定或不同程度提高，手术前后视力差异具有统计学意义(Z=-4.128，P=0.000)。术前平均眼压15.29±3.62mmHg，术后6mo平均眼压13.67±4.93mmHg。其中糖尿病性视网膜病变96眼(46.2%)，视网膜分支静脉阻塞37眼(17.8%)，视网膜中央静脉阻塞9眼(4.3%)，视网膜静脉周围炎13眼(6.25%)，息肉样脉络膜视网膜病13眼(6.25%)，视网膜大动脉瘤5眼(2.4%)，视网膜裂孔19眼(9.1%)，Terson综合征16眼(7.7%)。术中联合白内障手术23眼(11.1%)，术中玻璃体腔填充灌注液145眼(69.7%)，C₃F₈气体21眼(10.1%)，空气17眼(8.2%)，硅油25眼(12.0%)。术后并发症：12眼(5.8%)出现术后早期一过性低眼压，8眼(3.8%)术后早期高眼压，19眼(9.1%)出现前房炎症反应，10眼(4.8%)术后早期玻璃体再出血，余所有患者在治疗过程中及治疗后随访均未见眼部或全身不良反应。

结论：采用25G微创玻璃体切除术治疗玻璃体积血是安全有效的，具有创伤小、时间短、恢复快。

METHODS:A retrospective review of 200 patients(208 eyes)who were diagnosed as vitreous hemorrhage through the best-corrected visual acuity(BCVA),intraocular pressure(IOP),examination of slit lamp, examination of the ocular fundus and B-mode ultrasongography from January 2012 to June 2014 was taken. All patients were treated by 25G micro-incision vitrectomy. At 1wk,1,3 and 6 mo after the surgeries, the BCVA was retrospectively observed. The changes of IOP, inflammatory reaction and the ocular fundus were observed.

RESULTS: The BCVA was light perception in 16 eyes, hand moving in 82 eyes,finger counting in 49 eyes, 0.01～0.09 in 38 eyes,0.1～0.2 in 23 eyes pre-operatively. At 6mo after operations,the BCVA were hand moving in 1 eyes, finger counting in 2 eyes,0.01～0.09 in 31 eyes, 0.1～0.2 in 29 eyes,>0.2 in 145 eyes. The BCVA of all patients kept stable or increased after operations and the difference before and after the operation was statistically significant(Z=-4.128, P=0.000). The pre-operative mean IOP was 15.29±3.62mmHg. The mean IOP was 13.67±4.93mmHg at 6mo after operations. There were 96 eyes(46.2%)due to diabetic retinopathy,37 eyes(17.8%)due to branch retinal vein obstruction,9 eyes(4.3%)due to central retinal vein obstruction,13 eyes(6.25%)due to retinal periphlebitis,13 eyes(6.25%)due to polypoidal choroidal vasculopathy(PCV),5 eyes(2.4%)due to large retinal aneurys,19 eyes(9.1%)due to retinal hole,16 eyes(7.7%)due to Terson syndrome. Phacoemulcification was performed for 23 eyes(11.1%)during operations. There were 145 eyes(69.7%)with perfusion fluid,21 eyes(10.1%)with C₃F₈ gas tamponade,17 eyes(8.2%)with air tamponade,25 eyes(12.0%)with silicone oil tamponade. There were 12 eyes(5.8%)with transient hypotony, 8 eyes(3.8%)with increased IOP, 19 eyes(9.1%)with inflammation in anterior chamber, and 10 eyes(4.8%)with vitreous hemorrhage after the surgery. There were no ocular or systemic adverse events observed in other patients.

CONCLUSION: The 25G micro-incision vitrectomy is an effective and safe treatment for the patients with vitreous hemorrhage because of small injury, short operation time, quick recovery.