Le Rouic J F, Behar-Cohen F, Azan F, Bertin S, Bettembourg O, Rumen F, Caudron C, Renard G, Chauvaud D
Service d'Ophtalmologie, Hôtel-Dieu, 1, place du parvis Notre-Dame, 75004 Paris, France.
J Fr Ophtalmol. 2002 Mar;25(3):240-5.
Retinal detachment (RD) is a major complication of cataract surgery, which can be treated by either primary vitrectomy without indentation or the scleral buckling procedure. The aim of this study is to compare the results of these two techniques for the treatment of pseudophakic RD.
The charts of 40 patients (40 eyes) treated with scleral buckling for a primary pseudophakic RD were retrospectively studied and compared to the charts of 32 patients (32 eyes) treated with primary vitrectomy without scleral buckle during the same period by the same surgeons. To obtain comparable samples, patients with giant retinal tears, vitreous hemorrhage, and severe preoperative proliferative vitreoretinopathy (PVR) were not included. Minimal follow-up was 6 months.
The primary success rate was 84% in the vitrectomy group and 82.5% in the ab-externo group. Final anatomical success was observed in 100% of cases in the vitrectomy group and in 95% of cases in the ab-externo group. Final visual acuity was 0.5 or better in 44% of cases in the vitrectomy group and 37.5% in the ab-externo group. The duration of the surgery was significantly lower in the ab-externo group, whereas the hospital stay tended to be lower in the vitrectomy group. In the vitrectomy group, postoperative PVR developed in 3 eyes and new or undetected breaks were responsible for failure of the initial procedure in 2 eyes.
Primary vitrectomy appears to be as effective as scleral buckling procedures for the treatment of pseudophakic RD.
视网膜脱离（RD）是白内障手术的主要并发症，可通过不做压陷的一期玻璃体切除术或巩膜扣带术进行治疗。本研究的目的是比较这两种技术治疗人工晶状体眼视网膜脱离的效果。
回顾性研究40例（40眼）因一期人工晶状体眼视网膜脱离接受巩膜扣带术治疗患者的病历，并与同期由同一组外科医生进行一期玻璃体切除术（未行巩膜扣带）治疗的32例（32眼）患者的病历进行比较。为获得可比样本，排除患有巨大视网膜裂孔、玻璃体积血和严重术前增生性玻璃体视网膜病变（PVR）的患者。最短随访时间为6个月。
玻璃体切除术组的一期成功率为84%，外路手术组为82.5%。玻璃体切除术组100%的病例观察到最终解剖学成功，外路手术组为95%。玻璃体切除术组44%的病例最终视力为0.5或更好，外路手术组为37.5%。外路手术组的手术时间明显更短，而玻璃体切除术组的住院时间往往更短。在玻璃体切除术组中，3只眼发生了术后PVR，2只眼因新出现或未发现的裂孔导致初始手术失败。
一期玻璃体切除术在治疗人工晶状体眼视网膜脱离方面似乎与巩膜扣带术同样有效。
