目的：探讨经平坦部玻璃体切割手术(PPV)术前玻璃体腔注射重组组织纤溶酶原激活剂(r-TPA)对眼球破裂伤(RG)患者手术效果的影响。

方法：回顾性地收集2020年4月至2023年11月本院Ⅰ期缝合稳定后7-10 d行PPV的RG患者37例37眼，根据PPV术前1 d是否行玻璃体腔注射r-TPA，分为术前注射r-TPA组14例14眼及术前未注射r-TPA组23例23眼。比较两组患者PPV术中视网膜复位率、术中硅油应用情况、术后眼内再出血、术后低眼压及最佳矫正视力情况。

结果：两组患者术前一般资料具有可比性(P>0.05)。两组患者术中视网膜复位率、硅油填充量及术后最佳矫正视力占比均有差异(均P<0.05)，两组术中硅油填充率、术后眼内再出血情况、术后低眼压发生率无差异(均P>0.05)。

结论：PPV术前1 d接受r-TPA眼内注射的RG患者术中视网膜复位率和术后视力改善率更高。

METHODS: A retrospective study was conducted on 37 patients(37 eyes)with RG who underwent PPV 7-10 d after Stage Ⅰ suturing and stabilization at our hospital between April 2020 and November 2023. Based on whether an intravitreal r-TPA injection was administered 1 d before PPV, patients were divided into two groups, with 14 cases(14 eyes)in pre-operative r-TPA injection group, and 23 cases(23 eyes)in control group without pre-operative r-TPA injection. The intraoperative retinal reattachment rate, intraoperative silicone oil application, postoperative intraocular rebleeding, postoperative hypotony, and best-corrected visual acuity(BCVA)were compared between the two groups.

RESULTS: The baseline characteristics were comparable between the two groups(P>0.05). Significant differences were found between the two groups in the intraoperative retinal reattachment rate, the volume of silicone oil injected, and the proportion of BCVA(all P<0.05). No statistically significant differences were observed in the intraoperative silicone oil tamponade rate, postoperative intraocular rebleeding, or postoperative hypotony rates(all P>0.05).

CONCLUSION: RG patients who received an intravitreal r-TPA injection 1 d before PPV demonstrated significantly higher intraoperative retinal reattachment rates and better postoperative visual acuity outcomes.