Stangos Alexandros N, Petropoulos Ioannis K, Brozou Catherine G, Kapetanios Anastasios D, Whatham Andrew, Pournaras Constantin J
Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
Am J Ophthalmol. 2004 Dec;138(6):952-8. doi: 10.1016/j.ajo.2004.06.086.
To compare primary pars-plana vitrectomy (PPV) alone vs vitrectomy with an encircling scleral buckling procedure for the treatment of primary rhegmatogenous pseudophakic retinal detachment (PsRD).
Prospective, nonrandomized, comparative study.
All 71 eyes of 68 consecutive patients with PsRD presented to our service between 1998 and 2002 were offered either vitrectomy alone (group-A) or vitrectomy in combination with encircling scleral buckling procedure (group-B). Preoperative and postoperative patient characteristics were recorded in detail. Main outcome measures were reattachment with a single surgery, visual acuity, and reattachment surgery-related complications.
Retina reattachment with a single surgery was achieved in 97.78% in group A and 92.31% in group B. Visual acuity improved by 3 or more lines in 60% in group A and 69% in group B. Mean postoperative refractive error change (spherical) was -0.05 diopters in group A and -1.43 diopters in group B. Postoperative intraocular pressure on long-term follow-up was elevated in 4.44% (group A) and 34.61% (group B). Average follow-up was 12.45 months (+/-5.23 SD) ranging from 9 to 40 months. We detected additional breaks intraoperatively in 54.9% of cases (both groups).
Vitrectomy is an effective initial treatment for PsRD, whereas the benefit of an additional encircling buckling procedure is questionable.
比较单纯原发性玻璃体切除术（PPV）与玻璃体切除术联合环扎巩膜扣带术治疗原发性孔源性假晶状体性视网膜脱离（PsRD）的效果。
前瞻性、非随机、对照研究。
1998年至2002年间，68例连续患有PsRD的患者共71只眼被纳入研究，这些患者被分为单纯玻璃体切除术组（A组）或玻璃体切除术联合环扎巩膜扣带术组（B组）。详细记录术前和术后患者的特征。主要观察指标为单次手术视网膜复位情况、视力及视网膜复位手术相关并发症。
A组单次手术视网膜复位率为97.78%，B组为92.31%。A组60%患者视力提高3行或更多，B组为69%。A组术后平均屈光不正变化（球镜）为-0.05屈光度，B组为-1.43屈光度。长期随访中，A组4.44%、B组34.61%患者术后眼压升高。平均随访时间为12.45个月（标准差±5.23），范围为9至40个月。术中两组均有54.9%的病例发现额外裂孔。
玻璃体切除术是治疗PsRD的有效初始治疗方法，而额外的环扎扣带术的益处值得怀疑。
