方法：回顾性分析近年来我院手术治疗的出现严重并发症的XLRS患者，所有纳入研究的25例31眼患者术前OCT检查均存在黄斑区异常伴/不伴周边视网膜劈裂。我们根据患眼术前有无进行激光治疗将其分成A，B两组。A组15眼在术前已行视网膜激光治疗； B组16眼术前未行视网膜激光治疗。入组的全部31眼均行经扁平部玻璃体切割手术，内界膜剥除，气体或硅油填充。A组视术前光凝情况补/不补激光，B组均在注气或注油前行视网膜光凝治疗。术后随访3a，分析术后解剖复位情况和视功能结果。使用SPSS 13.0软件对手术前后平均视力数据进行统计分析，行配对t检验。A，B两组手术前后平均视力组间变化值差异，行单因素方差分析。

结果：末次随访中，玻璃体积血者术后屈光间质透明，视网膜脱离者术后视网膜复位良好，视力提高者23眼，占所有病例74.2%； 术后平均视力0.24±0.16，与治疗前平均视力(0.13±0.08)比较，差异具有统计学意义(t=-5.354，P=0.000)。A组平均视力由术前0.11±0.08提高至0.22±0.15(t=-4.391，P=0.000)，B组由术前0.14±0.08提高到0.26±0.15(t=-4.488，P=0.000)，差异均具有统计学意义。但比较两组的平均视力提高值，两组间手术前后变化无明显统计学差异(F=4.055，P=0.069)。随访期间有3眼出现并发症，1眼在术后3mo并发白内障，另2眼分别在术后10，12mo发生牵引性视网膜脱离。其中1眼发生于A组患者，2眼发生于B组患者，经再次手术，预后良好，且视网膜劈裂无明显进展。

结论：玻璃体视网膜手术用于治疗先天性视网膜劈裂症眼后段并发症，能有效阻止劈裂腔进一步发展，有助于改善和稳定视功能，恢复视网膜解剖结构。

METHODS: A retrospective study was made on all the XLRS patients with severe complications after operation in this hospital. All the 25 patients(31 eyes)present with macular abnormalities with/without peripheral retina split bypreoperative OCT examination. Among the 31 eyes, there were 7 eyes with vitreous hemorrhage, 8 eyes with retinal detachment and vitreous hemorrhage, and 16 eyes with rhegmatogenous retinal detachment. All the 31 eyes were divided into 2 groups: group A included 15 eyes which underwent photocoagulation before the surgery, while the other 16 eyes in group B didn't perform photocoagulation before the surgery. All the patients underwent a pars plana vitrectomy without lensectomy associated with internal limiting membrane peeling. Photocoagulation was done to the retinal holes and degeneration areas in group A. Gas or silicone oil was filled in group B after retinal photocoagulation treatment. Three years later, analysis was made on the results of the visual acuity, postoperative anatomical and functional outcome in these 2 groups. Statistical analysis was made on the results of average visual acuity before and after operation by SPSS software method, the difference was statistically significant(P<0.05). The differences of changes of visual acuity in two groups were statistically significant by one-way analysis of variance method.

RESULTS: Postoperative anatomical and functional outcome were satisfied at the last visit. A total of 23 eyes'(74.2%)visual acuity were improved with the mean visual acuity increasing from 0.13±0.08 to 0.24±0.16, the difference was statistically significant(t=-5.354,P=0.000). The average visual acuity in group A was improved from 0.11±0.08 to 0.22±0.15 after operation(t=-4.391, P=0.000). While the average visual acuity in group B increased from 0.14±0.08 to 0.26±0.15(t=-4.488, P=0.000). The visual changes in two groups were statistical significance. But when compared the average changes of visual acuity before and after operation between two groups, F=4.055, P=0.069, there was no statistical significance. During the following-up period, the complications were found in three eyes, among which two eyes presented with proliferative vitroretinopathy and traction retinal detachment 10 and 12 months after surgery, and one eye presented with cataract 3 months after surgery. Two eyes belonged to group A while the third eye pertain to group B. After reoperation, all the three eyes have good prognosis and retinoschisis didn't worsen.

CONCLUSION: Vitreoretinal surgery can be applied to the treatment of X-linked congenital retinoschisis and its complication, effectively preventing the deterioration of schisis cavity and contributing to the improvement and stabilization of visual acuity and resuming the anatomic structure of retina.