目的：比较25G玻璃体切割术(PPV)联合空气或硅油填充治疗孔源性视网膜脱离(RRD)的疗效。

方法：前瞻性随机对照研究。收集2018-01/12经我院确诊的RRD患者146例146眼，根据25G PPV术后眼内填充物分为空气组(60例60眼)和硅油组(86例86眼)。术后随访6～12mo，分析两组患者最佳矫正视力(BCVA)、眼压、视网膜解剖复位率及并发症情况。

结果：术后1mo，空气组患者BCVA为0.45±0.5，硅油组为0.78±0.65，两组患者BCVA均较术前明显改善，且空气组患者BCVA明显优于硅油组(均P<0.05)。术后3mo，空气组患者视网膜解剖复位率(93.3%)低于硅油组(97.7%)，但无差异； 术后6mo，两组患者视网膜解剖复位率均为100.0%。本研究纳入患者术中主要并发症是医源性裂孔(6.8%)，术后主要并发症是高眼压，术后早期(7d内)硅油眼高眼压比例明显高于空气组(P<0.001)，但随访期间两组患者均未出现感染性眼内炎、脉络膜出血等严重并发症。

结论：对于简单新鲜的RRD患者，25G PPV术后空气和硅油填充视网膜解剖复位率无差别，术后早期空气填充眼视力优于硅油填充眼，术后高眼压发生率更低。

METHODS: A prospective, randomized comparative study. 146 eyes from 146 patients who underwent 25G transconjunctival sutureless vitrectomy to repair rhegmatogenous retinal detachment were performed. Totally 60 eyes used air tamponade but 86 eyes used silicone oil tamponade. The follow-up time ranged from 6-12mo. The best corrected visual acuity(LogMAR), intraocular pressure, retinal reattachment rate, intraoperative and postoperative complications were compared.

RESULTS: One month after surgery, the mean BCVA was 0.45±0.5 in the air tamponade group and 0.78±0.65 in the silicone oil tamponade group, it were both evidently improved in comparison with before surgery, what's more, air tamponade had significantly better BCVA than those in the silicone oil tamponade(both P<0.05). 3mo after surgery, the reattachment rate of patients in air group was lower than that of silicone oil group(93.3% vs 97.7%), but had no significant differences between the two groups. 6mo after surgery, the anatomical success rate were 100% in both groups. The main intraoperative complication was iatrgenic retinal breaks in 10 eyes(6.8%). The main postoperative complication was high intraocular pressure, the intraocular pressure 1wk after surgery in the silicone oil tamponade group was evidently higher than that air tamponade group(P<0.001). No serious complication such as endophthalmitis and choroidal hemorrhage were observed in both groups.

CONCLUSION: For the simple early RRD, air tamponade had equivalent reattachment rate to silicone oil tamponade after 25G PPV. In the early postoperative, the visual acuity of air group was better comparing with silicone oil group, and was lower incidence of high intraocular pressure.