Schwartz Stephen G, Flynn Harry W
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
Curr Opin Ophthalmol. 2006 Jun;17(3):245-50. doi: 10.1097/01.icu.0000193097.28798.fc.
There remains no consensus among vitreoretinal surgeons regarding the optimal management of primary rhegmatogenous retinal detachment. In this article, fundamental principles are discussed and applied to recent clinical reports.
The consensus of the peer-reviewed literature appears to be that scleral buckling and primary pars plana vitrectomy may yield comparable single-operation success rates and visual acuity outcomes for a wide variety of rhegmatogenous retinal detachments.
No definitive prospective, randomized, multicenter trial compares scleral buckling with pars plana vitrectomy. The upcoming Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment study may yield useful information in this regard. Even when this study is completed, the choice of surgical modality is complex and may be individualized for specific patients.
在原发性孔源性视网膜脱离的最佳治疗方法上,玻璃体视网膜外科医生尚未达成共识。本文讨论了基本原则并应用于近期临床报告。
同行评审文献的共识似乎是,对于多种孔源性视网膜脱离,巩膜扣带术和原发性玻璃体切除术可能产生相当的单次手术成功率和视力结果。
尚无明确的前瞻性、随机、多中心试验比较巩膜扣带术和玻璃体切除术。即将开展的“孔源性视网膜脱离的巩膜扣带术与原发性玻璃体切除术对比研究”可能会在这方面提供有用信息。即使这项研究完成,手术方式的选择也很复杂,可能需要针对特定患者进行个体化选择。