Miki D, Hida T, Hotta K, Shinoda K, Hirakata A
Department of Ophthalmology, Kyorin University, School of Medicine, Mitaka, Japan.
Nippon Ganka Gakkai Zasshi. 2000 Jan;104(1):24-8.
We compared the surgical results of vitrectomy and scleral buckling for uncomplicated superior retinal detachment caused by flap tears.
Included in the study were 225 phakic eyes of 225 patients undergoing primary surgery from January 1990 to December of 1996 for superior retinal detachment caused by flap tears; all eyes had been followed for longer than six months after surgery. The choice of procedures was based on each surgeon's preference. The cases were evaluated retrospectively and the surgical outcome and the rate of complications compared between the two groups of eyes.
Initial and final anatomical success rate were 92% and 100% after each procedure. Redetachment after the first procedure was due to new retinal breaks in 5 eyes, reopening of original breaks in 2 eyes of vitrectomy cases, and malpositioned buckle in 11 eyes of scleral buckling cases. Proliferative vitreoretinopathy occurred in 3 eyes of vitrectomy cases.
Primary vitrectomy was as successful as scleral buckling for superior rhegmatogenous retinal detachment. Although a high incidence of postoperative cataract formation was a major drawback, vitrectomy had some advantages over to scleral buckling.
我们比较了玻璃体切除术和巩膜扣带术治疗因瓣状裂孔导致的单纯性视网膜脱离的手术效果。
研究纳入了1990年1月至1996年12月期间因瓣状裂孔导致视网膜脱离而接受初次手术的225例患者的225只屈光间质清晰的眼睛;所有眼睛术后均随访超过6个月。手术方式的选择基于每位外科医生的偏好。对病例进行回顾性评估,并比较两组眼睛的手术结果和并发症发生率。
每种手术术后的初始和最终解剖成功率分别为92%和100%。首次手术后视网膜再脱离的原因,玻璃体切除术组有5只眼是由于新的视网膜裂孔,2只眼是原裂孔重新开放;巩膜扣带术组有11只眼是由于扣带位置不当。玻璃体切除术组有3只眼发生了增殖性玻璃体视网膜病变。
对于原发性孔源性视网膜脱离,玻璃体切除术与巩膜扣带术同样成功。虽然术后白内障形成的发生率较高是一个主要缺点,但玻璃体切除术相对于巩膜扣带术有一些优势。