Foster Robert E, Meyers Sanford M
Cincinnati Eye Institute, Cincinnati, Ohio. Division of Ophthalmology, Lutheran General Hospital, Park Ridge, Illinois, USA.
Ophthalmology. 2002 Oct;109(10):1821-7. doi: 10.1016/s0161-6420(02)01182-x.
Little information exists regarding recurrent retinal detachment after 1 or more years of complete retinal reattachment. To better understand this uncommon problem, we evaluated late recurrent retinal detachments in relation to the contemporary classification of proliferative vitreoretinopathy (PVR).
Retrospective consecutive noncomparative case series.
Nine patients (10 eyes) with late recurrent retinal detachment after 1 or more years of complete reattachment.
We retrospectively analyzed the clinical and operative records of one surgeon over a 9-year period to identify late recurrent retinal detachments that occurred 1 or more years after complete retinal reattachment. The study group was derived from a total of 453 consecutive cases of rhegmatogenous retinal detachment repair not associated with proliferative diabetic retinopathy, uveitis, or penetrating ocular trauma.
Late recurrent retinal detachments after 1 or more years of complete retinal reattachment.
The study group consisted of 10 eyes (2.2% of total) in nine patients. Redetachment occurred from 12 to 126 months (average, 46.8 months) after the initial detachment surgery. Late recurrent retinal detachments were associated with new retinal breaks (five eyes), reopening of old breaks (three eyes), or both (two eyes). In all, 13 open breaks were identified, nine of which were on or anterior to the scleral buckle. Eight eyes had grade C PVR, including four eyes with anterior PVR, three eyes with posterior PVR, and one eye with both anterior and posterior PVR. The retina was reattached after additional vitreoretinal surgery in eight eyes of seven patients; two patients (two eyes) declined reoperation. Visual acuity improved in seven of eight eyes after repair of the late recurrent retinal detachment. Postoperative follow-up after late recurrent detachment repair ranged from 69 to 140 months (average, 101.7 months, or 8.5 years).
Vitreous base traction seems to be an important factor in late recurrent retinal detachments occurring 1 or more years after complete retinal reattachment, and the associated PVR was probably a secondary phenomenon and not a causative factor in most cases. Reoperation for such late recurrent retinal detachments can successfully reattach the retina and improve visual acuity in most cases.
关于视网膜完全复位1年或更长时间后复发性视网膜脱离的信息很少。为了更好地理解这个不常见的问题，我们根据增殖性玻璃体视网膜病变（PVR）的当代分类对晚期复发性视网膜脱离进行了评估。
回顾性连续非对照病例系列。
9例患者（10只眼），在视网膜完全复位1年或更长时间后发生晚期复发性视网膜脱离。
我们回顾性分析了一位外科医生在9年期间的临床和手术记录，以确定在视网膜完全复位1年或更长时间后发生的晚期复发性视网膜脱离。研究组来自453例连续的孔源性视网膜脱离修复病例，这些病例与增殖性糖尿病视网膜病变、葡萄膜炎或穿透性眼外伤无关。
视网膜完全复位1年或更长时间后的晚期复发性视网膜脱离。
研究组包括9例患者的10只眼（占总数的2.2%）。视网膜脱离复发发生在初次脱离手术后12至126个月（平均46.8个月）。晚期复发性视网膜脱离与新的视网膜裂孔（5只眼）、陈旧裂孔重新开放（3只眼）或两者都有（2只眼）有关。总共发现13个开放性裂孔，其中9个位于巩膜扣带或其前方。8只眼有C级PVR，包括4只眼前部PVR、3只眼后部PVR和1只眼同时有前部和后部PVR。7例患者的8只眼在接受额外的玻璃体视网膜手术后视网膜复位；2例患者（2只眼）拒绝再次手术。8只眼中有7只眼在晚期复发性视网膜脱离修复后视力提高。晚期复发性脱离修复后的术后随访时间为69至140个月（平均101.7个月，即8.5年）。
玻璃体基底部牵引似乎是视网膜完全复位1年或更长时间后晚期复发性视网膜脱离的一个重要因素，并且在大多数情况下，相关的PVR可能是一种继发现象而非致病因素。对于这种晚期复发性视网膜脱离进行再次手术在大多数情况下可以成功使视网膜复位并提高视力。
