Guillaubey Alexandre, Malvitte Laure, Lafontaine Pierre Olivier, Hubert Isabelle, Bron Alain, Berrod Jean Paul, Creuzot-Garcher Catherine
Department of Ophthalmology, Univeristy Hospital Dijon, Dijon, France.
Br J Ophthalmol. 2007 Oct;91(10):1327-30. doi: 10.1136/bjo.2007.115162. Epub 2007 May 23.
To evaluate the rate of retinal detachment after macular surgery.
A retrospective non-randomised study of 634 macular surgery procedures was undertaken in two academic centres. Idiopathic macular hole (IMH) surgery (n = 272) and epiretinal membrane (ERM) surgery (n = 362) were performed between 2000 and 2003. We noted the anatomical and functional results of these procedures and we studied serious complications excluding cataract.
Minimum follow up was 1 year. No retinal detachment (RD) occurred in patients presenting with an intraoperative or preoperative successfully treated retinal break (RB). The rate of RD occurring after IMH surgery was higher than after the ERM surgical procedure (6.6% vs 2.5%, p = 0.02). The rate of RD was higher in patients presenting with stage 2 and 3 IMH than with stage 4 IMH. However, lens status as well as preoperatively treated RD did not influence the rate of RD after macular surgery.
Retinal detachment remains the most common serious complication of macular surgery. Surgical detachment of the posterior vitreous face and associated peripheral retina anomaly seem to increase the rate of this complication. Careful examination of the peripheral retina is a key issue in preventing retinal detachment occurring after macular surgery.
评估黄斑手术后视网膜脱离的发生率。
在两个学术中心对634例黄斑手术进行了一项回顾性非随机研究。2000年至2003年间进行了特发性黄斑裂孔(IMH)手术(n = 272)和视网膜前膜(ERM)手术(n = 362)。我们记录了这些手术的解剖和功能结果,并研究了除白内障外的严重并发症。
最短随访时间为1年。术中或术前成功治疗视网膜裂孔(RB)的患者未发生视网膜脱离(RD)。IMH手术后发生RD的发生率高于ERM手术后(6.6%对2.5%,p = 0.02)。2期和3期IMH患者的RD发生率高于4期IMH患者。然而,晶状体状态以及术前治疗的RD并未影响黄斑手术后的RD发生率。
视网膜脱离仍然是黄斑手术最常见的严重并发症。玻璃体后表面的手术分离及相关周边视网膜异常似乎会增加该并发症的发生率。仔细检查周边视网膜是预防黄斑手术后发生视网膜脱离的关键问题。