Lai Michael M, Ruby Alan J, Sarrafizadeh Ramin, Urban Kate E, Hassan Tarek S, Drenser Kimberly A, Garretson Bruce R
Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, Michigan, USA.
Retina. 2008 May;28(5):729-34. doi: 10.1097/IAE.0b013e318162b01c.
: To evaluate the anatomical and visual outcomes of primary rhegmatogenous retinal detachment repairs performed using 25-gauge transconjunctival sutureless vitrectomy.
: A retrospective, noncomparative interventional case series including 53 consecutive eyes of 52 patients who underwent 25-gauge transconjunctival sutureless vitrectomy to repair primary rhegmatogenous retinal detachment was performed. Variables collected for the study were patient demographics, lens status, preoperative visual acuity, and macular status. Outcome measures included single-operation anatomical success rate, final anatomical success rate, postoperative visual acuity, and surgical complications.
: The retina was reattached with a single operation in 39 (74%) of 53 eyes. The final anatomical success rate was 100%. The mean time to redetachment was 72 days (range, 13-334 days). Proliferative vitreoretinopathy (64%) and development of new retinal breaks (43%) were the most common reasons associated with redetachment. Mean visual acuity improved from 20/100 to 20/60 (P = 0.001); 55% of eyes had final vision of 20/40 or better. Three eyes (6%) developed postoperative choroidal hemorrhage. Three eyes (6%) developed visually significant macular pucker that required surgery. No postoperative hypotony or endophthalmitis was observed.
: Repair of primary rhegmatogenous retinal detachments using 25-gauge transconjunctival sutureless vitrectomy resulted in excellent final anatomical success rate and postoperative visual outcomes. However, redetachments due to new tears and/or proliferative vitreoretinopathy resulted in a lower single-operation success rate than those reported with 20-gauge systems.
评估使用25G经结膜无缝合玻璃体切除术治疗原发性孔源性视网膜脱离的解剖学和视觉效果。
进行一项回顾性、非对照性干预病例系列研究，纳入52例患者的53只连续眼睛，这些患者接受了25G经结膜无缝合玻璃体切除术以修复原发性孔源性视网膜脱离。研究收集的变量包括患者人口统计学资料、晶状体状态、术前视力和黄斑状态。观察指标包括单次手术解剖成功率、最终解剖成功率、术后视力和手术并发症。
53只眼中有39只（74%）通过单次手术使视网膜复位。最终解剖成功率为100%。再次脱离的平均时间为72天（范围13 - 334天）。增殖性玻璃体视网膜病变（64%）和新的视网膜裂孔形成（43%）是与再次脱离相关的最常见原因。平均视力从20/100提高到20/60（P = 0.001）；55%的眼睛最终视力达到20/40或更好。3只眼（6%）发生术后脉络膜出血。3只眼（6%）出现具有临床意义的黄斑前膜，需要手术治疗。未观察到术后低眼压或眼内炎。
使用25G经结膜无缝合玻璃体切除术修复原发性孔源性视网膜脱离可获得优异的最终解剖成功率和术后视觉效果。然而，由于新裂孔和/或增殖性玻璃体视网膜病变导致的再次脱离，使得单次手术成功率低于20G系统报道的成功率。
