Chauhan Devinder S, Downie John A, Eckstein Michael, Aylward G W
Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, England.
Arch Ophthalmol. 2006 Jul;124(7):968-71. doi: 10.1001/archopht.124.7.968.
To describe adverse sequelae of retinal prophylaxis in fellow eyes of patients with rhegmatogenous retinal detachment.
Records were reviewed for 17 patients who had retinal breaks or detachment subsequent to prophylactic retinopexy applied to the fellow eye (without posterior vitreous detachment) at the time of primary rhegmatogenous retinal detachment surgery. Subsequent treatment included cryotherapeutic and laser retinopexy, scleral buckling, and vitrectomy.
Of the 17 patients, 12 were male (mean age, 49 years). Laser retinopexy alone was used in 6 cases. Sixteen (94%) developed retinal tears related to acute posterior vitreous detachment, of which 8 (47%) were at the edge of retinopexy and 8 (47%) were in the normal or untreated retina. Thirteen (76%) developed a retinal detachment, of which 11 (85%) did not involve the fovea. Median visual acuity following treatment was 0.18 logMAR (6/9 Snellen equivalent).
Prophylactic retinopexy in fellow eyes without posterior detachment is not completely successful and may cause breaks to develop at the edge of treated areas during subsequent acute posterior vitreous detachment. Patient education alone regarding the symptoms of retinal tear and detachment may be preferable to prophylactic retinopexy of the fellow eye in the absence of a posterior vitreous detachment.
描述孔源性视网膜脱离患者对侧眼视网膜预防性治疗的不良后遗症。
回顾了17例患者的记录，这些患者在原发性孔源性视网膜脱离手术时，对侧眼（无玻璃体后脱离）接受了预防性视网膜光凝治疗，随后出现视网膜裂孔或脱离。后续治疗包括冷冻治疗、激光视网膜光凝、巩膜扣带术和玻璃体切除术。
17例患者中，12例为男性（平均年龄49岁）。6例仅采用激光视网膜光凝治疗。16例（94%）出现与急性玻璃体后脱离相关的视网膜裂孔，其中8例（47%）位于视网膜光凝边缘，8例（47%）位于正常或未治疗的视网膜。13例（76%）发生视网膜脱离，其中11例（85%）未累及黄斑。治疗后的中位视力为0.18 logMAR（相当于6/9 Snellen视力）。
对无玻璃体后脱离的对侧眼进行预防性视网膜光凝并不完全成功，可能会在随后的急性玻璃体后脱离期间导致治疗区域边缘出现裂孔。在没有玻璃体后脱离的情况下，仅对患者进行视网膜裂孔和脱离症状的教育可能比对侧眼预防性视网膜光凝更可取。
