Afrashi Filiz, Erakgun Tansu, Akkin Cezmi, Kaskaloglu Mahmut, Mentes Jale
Department of Opthalmology, Ege University School of Medicine, Bornova, Izmir, Turkey.
Graefes Arch Clin Exp Ophthalmol. 2004 Apr;242(4):295-300. doi: 10.1007/s00417-003-0842-2. Epub 2004 Jan 9.
There is controversy about the most appropriate operating methods for complicated rhegmatogenous retinal detachment (RD) including multiple tears, and surgical techniques may be changed according to the preference of the surgeon. In this retrospective study, we compared the surgical results of conventional buckling surgery and vitrectomy with silicone oil tamponade for rhegmatogenous (RD) with multiple breaks.
Thirty patients who underwent scleral buckling surgery (group 1) and 22 patients who underwent pars plana vitrectomy with silicone oil tamponade (group 2) as the primary surgery for rhegmatogenous RD with multiple breaks were included in this study. The follow-up period was longer than 6 months after surgery. The anatomical success rates and complications were evaluated for both groups.
Retinal reattachment was achieved in 24 of 30 eyes (80%) in group 1 and in 20 of 22 eyes (90.9%) in group 2 after the initial surgery. In group 1, subretinal hemorrhage developed due to the drainage of subretinal fluid in 2 eyes (6.6%) intraoperatively. Elevated intraocular pressure (3.3%), ocular motility disturbances (13.2%), and proliferative vitreoretinopathy (3.3%) were seen in the postoperative period. In group 2, iatrogenic breaks (7.3%) and lens damage (9.09%) occurred during the operation. Macular pucker (4.5%), postoperative cataract progression (22.7%), ocular hypertension (9.09%) and PVR (9.09%) were noted postoperatively.
Both surgical procedures can achieve favorable and comparable anatomic outcomes in the majority of patients in the treatment of RD with multiple breaks. Intra-and postoperative complications are different in the two procedures.
对于包括多个裂孔在内的复杂性孔源性视网膜脱离（RD），最合适的手术方法存在争议，手术技术可能会根据外科医生的偏好而改变。在这项回顾性研究中，我们比较了传统巩膜扣带术和玻璃体切除术联合硅油填充治疗多发性裂孔性孔源性视网膜脱离（RD）的手术效果。
本研究纳入了30例行巩膜扣带术的患者（第1组）和22例行玻璃体切除术联合硅油填充的患者（第2组），这些患者均以多发性裂孔性孔源性视网膜脱离作为初次手术治疗对象。随访期为术后6个月以上。评估两组的解剖学成功率和并发症情况。
初次手术后，第1组30只眼中有24只（80%）视网膜复位，第2组22只眼中有20只（90.9%）视网膜复位。在第1组中，术中2只眼（6.6%）因视网膜下液引流出现视网膜下出血。术后出现眼压升高（3.3%）、眼球运动障碍（13.2%）和增殖性玻璃体视网膜病变（3.3%）。在第2组中，手术期间发生医源性裂孔（7.3%）和晶状体损伤（9.09%）。术后发现黄斑皱缩（4.5%）、术后白内障进展（22.7%）、高眼压（9.09%）和增殖性玻璃体视网膜病变（9.09%）。
在治疗多发性裂孔性视网膜脱离时，两种手术方法在大多数患者中都能取得良好且相当的解剖学效果。两种手术的术中及术后并发症有所不同。
