目的 :探讨不同的手术方式对伴脉络膜脱离 (脉脱 )的孔源性视网膜脱离病例的预后影响。方法 :139例 140眼中 级膜 5 7眼 ( 40 .7% ) , A级膜 6 2眼 ( 44 .3% ) . B级膜 2 1眼 ( 15 .0 % )。 6 4眼行环扎加压手术 ( scleral buckling surgery,SB) ,76眼行闭合式玻璃体切除手术 ( closed virteous surgery.CV)。结果 :术后随访时间均大于 3月 ,最长达 2年 ,平均 3.7月 ,一次手术复位 10 9眼 ( 77.9% ) ,最终复位率 89.3% ( 12 5 / 140 )。 级膜中 SB、CV一次手术复位率分别为 82 .1%、 94.4% ( P>0 .0 5 ) ,其中裂孔大小合计 >3PD的 SB、CV一次手术复位率分别为 5 8.3%、 92 .3% ( P<0 .0 5 ) ; A级膜中 SB、CV一次手术复位率分别为 6 4.0 %、 86 .4% ( P<0 .0 5 ) ; B级膜均采用 CV手术 ,一次手术复位率 5 7.1%。结论 :对于膜形成不严重的 级膜行 SB手术比较合适 ,但裂孔合计 >3PD的宜行 CV手术 ,对于 A级膜及以上的行 CV手术更合适 Objective: To investigate the prognostic impact of different surgical modalities on rhegmatogenous retinal detachment with choroidal detachment (pulse off). Methods: One hundred and ninety-three eyes of middle-grade were 57 eyes (40.7%), 62 eyes (44.3%) of grade A, and 21 eyes (15.0%) of grade B. Sixty-four eyes underwent scleral buckling surgery (SB) and 76 underwent closed virtuated surgery (CVC). Results: All patients were followed up for more than 3 months. The longest time was 2 years (average 3.7 months). One operation was performed in 109 eyes (77.9%) and the final reduction rate was 89.3% (125/144). The rates of primary surgical resection of SB and CV were 82.1% and 94.4% respectively (P> 0.05), and the rates of one-time surgical resection of SB and CV with the total fracture size> 3PD were 53.3% and 92% respectively. 3% (P <0.05). The rates of primary surgery in SB group and CV group were respectively 6 4.0% and 86.4% (P 0. 05) The surgical reduction rate was 51.1%. CONCLUSIONS: SB surgery, which is not serious for the formation of membrane, is appropriate, but CV surgery with a total of> 3PD in the hole is more suitable for Class A and above CV surgery