Woon W H, Burdon M A, Green W T, Chignell A H
Curr Opin Ophthalmol. 1995 Jun;6(3):76-9. doi: 10.1097/00055735-199506000-00013.
Retinal detachment surgery can now achieve a final reattachment rate in over 90% of cases. The operation of choice in most cases is that of external scleral buckling with or without drainage of subretinal fluid. However, in a minority of cases these techniques are difficult to apply either when the breaks are unseen due to media opacities or when the breaks are complex, eg, posterior, large, or multiple breaks at different distances from the ora. Improvements in the technique of pars plana vitrectomy for retinal detachment now offers us an alternative method for treating these difficult cases. Pars plana vitrectomy for retinal detachments with unseen or complex breaks has a final attachment rate of over 90%, is technically easier to perform than conventional surgery, and avoids the refractive and ocular motility problems associated with complicated buckles. For these reasons and despite the high risk of nuclear sclerosis in phakic eyes, a pars plana vitrectomy may be the preferred option in selected cases of primary retinal detachment.
视网膜脱离手术目前在超过90%的病例中可实现最终复位率。大多数情况下的首选手术是巩膜外加压术，可联合或不联合视网膜下液引流。然而，在少数病例中，当由于介质混浊而无法看到裂孔时，或者当裂孔复杂时，例如后部、大的或多个位于距锯齿缘不同距离处的裂孔时，这些技术很难应用。用于视网膜脱离的扁平部玻璃体切除术技术的改进现在为我们提供了一种治疗这些疑难病例的替代方法。对于伴有隐匿或复杂裂孔的视网膜脱离，扁平部玻璃体切除术的最终复位率超过90%，在技术上比传统手术更容易实施，并且避免了与复杂加压相关的屈光和眼球运动问题。由于这些原因，尽管有晶状体眼发生核硬化的高风险，但在原发性视网膜脱离的某些选定病例中，扁平部玻璃体切除术可能是首选方案。
