目的 :探讨玻璃体手术中及术后可能导致视网膜脱离的各种原因 ,以便有效提高手术成功率。方法 :回顾性分析 2 6例玻璃体手术后视网膜脱离病例。通过再次玻璃体手术观察新破孔的位置、大小及其比邻关系 ,结合前次手术的有关资料 ,确定前次手术失败的原因。结果 :2 6例玻璃体手术后视网膜再脱离直接原因 (再网脱原因 ) :发生增殖性玻璃体视网膜病变 (PVR) 15例 ;术中遗漏视网膜裂孔(遗漏裂孔 ) 3例 ;巩膜切口玻璃体嵌顿 (玻璃体嵌顿 ) 5例 ;下方视网膜裂孔硅油充填不足 (硅油不足 ) 1例 ;视网膜裂孔缘翻卷 (孔缘翻卷 ) 1例 ;视网膜 Ar激光光凝形成视网膜孔 (激光孔 ) 1例。结论 :PVR是玻璃体手术失败的主要原因。巩膜切口玻璃体嵌顿导致的玻璃体手术失败应引起术者的关注。 Objective: To explore various reasons that may lead to retinal detachment during and after vitrectomy in order to effectively improve the success rate of surgery. Methods: A retrospective analysis of 26 cases of retinal detachment after vitreous surgery. Through the vitreous surgery to observe the location of the new hole, the size and the adjacent relationship, combined with the previous surgery of the relevant information to determine the reasons for the previous operation failed. Results: There were 26 direct cases of retinal reattachment after vitreous surgery (re-cytopathic reasons): 15 cases of proliferative vitreoretinopathy (PVR); 3 cases of missing retinal tears (missing holes) during surgery; Vitreous incarceration) in 5 cases; inferior retinal foramina was filled with silicone oil (insufficient silicone oil) in 1 case; retinal foramen margin was turned up in 1 case; retina was laser photocoagulated in 1 case. Conclusion: PVR is the main reason for the failure of vitreous surgery. Scleral incision vitreous incarceration led to the failure of vitreous surgery should cause the surgeon’s attention.