摘要目的:观察27G玻璃体切割手术（PPV）联合Healaflow覆盖封闭视网膜裂孔和空气填充治疗原发性孔源性视网膜脱离（RRD）的安全性和有效性。方法:以临床为基础的前瞻性连续研究。2017年3月至2018年5月于天津医科大学眼科医院检查确诊并行PPV治疗的原发性RRD患者50例51只眼纳入研究。患眼均行27G PPV，视网膜完全复位后，视网膜裂孔周围及变性区行激光光凝；使用27G钝性针头将Healaflow完全覆盖于视网膜裂孔表面，注射量根据视网膜裂孔大小确定，以裂孔完全被包含为标准。手术后无体位限制。手术后平均随访时间（15.8±6.3）个月。观察首次和最终视网膜复位率、BCVA、视网膜脱离复发情况；手术中、手术后并发症等。结果:50例51只眼纳入研究。其中，男性29例（58.0% ），女性21例（42.0% ）。平均年龄（58.5±11.2）岁。单一裂孔28只眼（54.9%）；2~5个裂孔23只眼（45.1 %）。是否累及黄斑区分别为32 （62.7%），19 （37.3%）只眼。首次视网膜复位50只眼（98.0% ），最终所有患眼均复位（100.0% ）。手术前、手术后3个月logMAR BCVA分别为0.95±0.80、0.22±0.17；手术前后logMAR BCVA比较，差异有统计学意义（ t=7.336， P<0.001 ）。手术后一过性眼压升高31只眼（60.8% ）。随访期间无其他并发症发生。 结论:27G PPV联合Healaflow覆盖视网膜裂孔和空气填充治疗原发性RRD，成功率高，视功能恢复快；安全、有效。

abstractsObjective:To observe the safety and effectiveness of patching retinal breaks with Healaflow in 27G vitrectomy combined with air tamponade in the treatment of rhegmatogenous retinal detachment (RRD).Methods:Clinical-based prospective continuous study. From March 2017 to May 2018, 51 eyes of 50 RRD patients diagnosed in Tianjin Medical University Eye Hospital were included in the study. All eyes were treated with 27G vitrectomy, and laser photocoagulation was performed around retinal hiatus and denaturation zone after complete retinal reattachment. A blunt 27G needle was used to completely cover the surface of the retinal tear with the Healaflow. The injection amount was determined according to the size of the retinal tear, and the standard was that the tear was completely contained. There was no postoperative position limitation. The average follow-up was 15.8±6.3 months. The primary and final anatomic attachment rate, BCVA after operation, the intraoperative and postoperative complications, the recurrence of retinal detachment and so on were recorded.Results:51 eyes of 50 patients were enrolled, including 29 males (58.0%) and 21 females (42.0%). The average age was 58.5±1 years. A single break was present in 28 eyes (54.9%) and 2 to 5 breaks in 23 eyes (45.1%). The macula was involved in 32 eyes (62.7%) and attached in 19 eyes (37.3%) intraoperatively. Initial reattachment was achieved in 50 eyes (98.0%) and final reattachment in 51 eyes (100.0%). The logMAR BCVA before and 3 months after operation were 0.95±0.80 and 0.22±0.17, respectively. The difference of logMAR BCVA between before and after operation was significant ( t=7.336, P<0.001). The intraocular pressure was elevated transiently in 31 eyes (60.8%). No other complications occurred during follow-up. Conclusion:The treatment of primary RRD with 27G vitrectomy combined with Healaflow patch and air tamponade is a safe, effective and convenient method with high success rate and rapid recovery of visual function.