Hassan Tarek S, Sarrafizadeh Ramin, Ruby Alan J, Garretson Bruce R, Kuczynski Barbara, Williams George A
Associated Retinal Consultants, PC, the Department of Ophthalmology, William Beaumont Hospital Eye Institute, 3535 West 13 Mile Road, Royal Oak, MI 48073, USA.
Ophthalmology. 2002 Jan;109(1):146-52. doi: 10.1016/s0161-6420(01)00886-7.
To present a current series that determined the effect of duration of macular detachment (DMD) and patient age on postscleral buckle (SB) visual acuity (VA) and anatomic results.
Retrospective, noncomparative, observational case series.
Ninety-four consecutive patients (94 eyes) with primary, uncomplicated, macula-off retinal detachments, a preoperative VA of 20/200 or worse, and a precise history of when macular function was lost.
Standard explant scleral buckle technique performed by multiple surgeons.
Visual acuity, anatomic reattachment, and proliferative vitreoretinopathy.
Visual acuity after SB of 20/40 or better was seen in 71% of eyes with a DMD of 10 days or fewer, 27% of eyes with a DMD of 11 days to 6 weeks, and 14% of eyes with a DMD of more than 6 weeks. Eyes achieved a mean VA after SB of 20/41 after a DMD of 10 days or fewer, 20/121 after a DMD of 11 days to 6 weeks, and 20/178 after a DMD of more than 6 weeks. No decrease in VA was seen within the 1- to 10-day period or the 11 days to 6 week period of DMD. Patients 60 years of age or less achieved a mean VA after SB of 20/47 compared with 20/81 for patients between 61 to 75 years of age and 20 of 96 in patients more than 76 years of age. Duration of macular detachment and patient age had no statistically significant effect on final anatomic reattachment after SB, reoperation rate, or proliferative vitreoretinopathy.
Eyes with primary, uncomplicated, macula-off retinal detachment repaired with SB achieve excellent postoperative VA if repaired within the first 10 days of macular detachment. These results are better than the VA in eyes repaired after 11 days to 6 weeks and more than 6 weeks of macular detachment. Patients 60 years of age and younger obtained better postoperative VA than older patients. Duration of macular detachment and patient age did not significantly effect anatomic outcomes.
呈现一个当前系列研究，该研究确定了黄斑脱离持续时间（DMD）和患者年龄对巩膜外加压术（SB）后视力（VA）及解剖学结果的影响。
回顾性、非对比性观察病例系列。
94例连续患者（94只眼），均为原发性、无并发症的黄斑脱离，术前视力为20/200或更差，且有黄斑功能丧失的确切时间记录。
由多位外科医生实施标准的外植体巩膜外加压技术。
视力、解剖复位及增殖性玻璃体视网膜病变。
DMD为10天或更短的眼中，71%在SB术后视力达到20/40或更好；DMD为11天至6周的眼中，27%达到该视力；DMD超过6周的眼中，14%达到该视力。DMD为10天或更短的眼在SB术后平均视力为20/41，DMD为11天至6周的眼为20/121，DMD超过6周的眼为20/178。在DMD的1至10天期间或11天至6周期间，视力未见下降。60岁及以下患者在SB术后平均视力为20/47，61至75岁患者为20/81，76岁以上患者为20/96。黄斑脱离持续时间和患者年龄对SB术后最终解剖复位、再次手术率或增殖性玻璃体视网膜病变无统计学显著影响。
对于原发性、无并发症的黄斑脱离行SB修复的眼，如果在黄斑脱离的前10天内修复，术后视力极佳。这些结果优于在黄斑脱离11天至6周及超过6周后修复的眼。60岁及以下患者术后视力优于老年患者。黄斑脱离持续时间和患者年龄对解剖学结果无显著影响。
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