Tunc M, Lahey J M, Kearney J J, Lewis J M, Francis R
Department of Ophthalmology, Kaiser-Permanante Medical Center, Union City, CA, USA.
Eye (Lond). 2007 Jun;21(6):831-4. doi: 10.1038/sj.eye.6702431. Epub 2006 May 19.
To determine the incidence of angiographic cystoid macular oedema (CMO) following pneumatic retinopexy (PR) and scleral buckling (SB) in consecutive case series.
Patients who had successful anatomical attachment following PR and SB were included in our study; 132 patients had PR and 121 patients had SB. We evaluated the demographic characteristics, visual acuity, lens status, macular status, and previous ocular history in all patients. CMO was evaluated by fluorescein angiography (FA) in a masked pattern, 6 and 12 weeks after surgery in all cases. We analysed the CMO incidence and its correlation with preoperative ocular status and visual outcome. Chi2 and Fisher's exact tests were used in statistical analysis.
CMO was present in 15 of 132 (11%) PR, and 35 of 121 (29%) SB patients at 6 weeks (P=0.0005); the oedema was persistent in eight of 132 (6%) PR and 21 of 121 (17%) SB patients at 12 weeks (P=0.0005). Eight of 106 (8%) phakic and seven of 26 (27%) pseudophakic patients developed CMO following PR (P=0.02). In the SB group, 26 of 72 (36%) patients who had preoperative macular detachment developed CMO (P=0.03). Visual improvement was limited in patients who developed angiographic CMO despite anatomical re-attachment of the retina.
CMO may occur following both PR and SB and deteriorate the visual outcome. Previous cataract surgery and macular detachment may increase the CMO rates following PR and SB, respectively.
在连续病例系列中确定气体视网膜固定术(PR)和巩膜扣带术(SB)后血管造影性黄斑囊样水肿(CMO)的发生率。
本研究纳入PR和SB术后解剖复位成功的患者;132例患者接受PR,121例患者接受SB。我们评估了所有患者的人口统计学特征、视力、晶状体状态、黄斑状态和既往眼部病史。所有病例均在术后6周和12周采用遮蔽模式通过荧光素血管造影(FA)评估CMO。我们分析了CMO的发生率及其与术前眼部状态和视力结果的相关性。统计分析采用卡方检验和Fisher精确检验。
6周时,132例PR患者中有15例(11%)发生CMO,121例SB患者中有35例(29%)发生CMO(P = 0.0005);12周时,132例PR患者中有8例(6%)水肿持续存在,121例SB患者中有21例(17%)水肿持续存在(P = 0.0005)。106例有晶状体眼患者中有8例(8%)在PR后发生CMO,26例人工晶状体眼患者中有7例(27%)在PR后发生CMO(P = 0.02)。在SB组中,术前黄斑脱离的72例患者中有26例(36%)发生CMO(P = 0.03)。尽管视网膜解剖复位,但发生血管造影性CMO的患者视力改善有限。
PR和SB后均可能发生CMO,并使视力结果恶化。既往白内障手术和黄斑脱离可能分别增加PR和SB后CMO的发生率。