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在人工晶状体眼视网膜脱离中采用斜向巩膜切口的25G原发性无缝线玻璃体切除术

Primary 25-gauge sutureless vitrectomy with oblique sclerotomies in pseudophakic retinal detachment.

作者信息

Acar Nur, Kapran Ziya, Altan Tugrul, Unver Yaprak Banu, Yurtsever Serap, Kucuksumer Yasar

机构信息

Beyoglu Eye Research and Training Hospital, Istanbul, Turkey.

出版信息

Retina. 2008 Oct;28(8):1068-74. doi: 10.1097/IAE.0b013e318176de6f.

Abstract

PURPOSE

To evaluate the anatomic and functional outcomes of 25-gauge sutureless vitrectomy in primary treatment of noncomplex pseudophakic rhegmatogenous retinal detachments (RRD).

METHODS

Prospective interventional institutional case series. Twenty-two eyes with pseudophakic RRD with proliferative vitreoretinopathy grade A or B underwent primary 25-gauge vitrectomy with oblique sclerotomies and gas endotamponade. Eyes with minimum follow-up of 6 months were evaluated. Main outcome measures were reattachment rate with single surgery, reoperation, complication rates, and changes in visual acuity (VA).

RESULTS

Mean duration of visual loss was 14.68 +/- 12.87 days. Seventeen (77.27%) eyes had macular detachment. In all eyes 25-gauge sutureless vitrectomy was completed without complications. The mean follow-up period was 10.40 +/- 5.77 months. Retinal attachment was achieved in 21 (95.45%) eyes with single surgery and in all (100%) eyes with second vitrectomy. Mean preoperative VA of 1.61 +/- 1.18 improved to 0.50 +/- 0.53 at the last visit (P < 0.001). Transient hypotony was detected in 2 (9.09%) eyes with spontaneous resolution. No other postoperative complication was observed.

CONCLUSIONS

Twenty-five-gauge sutureless vitrectomy with oblique sclerotomies in primary treatment of noncomplex pseudophakic RRDs resulted in reattachment in 95.45% with single surgery, and in 100% with reoperation in one eye, accompanied by an increase in visual acuity in 86% of eyes.

摘要

目的

评估25G无缝合玻璃体切除术在初次治疗非复杂性人工晶状体性孔源性视网膜脱离(RRD)中的解剖和功能结果。

方法

前瞻性干预性机构病例系列。22例患有增殖性玻璃体视网膜病变A级或B级的人工晶状体性RRD患者接受了初次25G玻璃体切除术,采用斜行巩膜切口和气液填充。对随访至少6个月的患者进行评估。主要观察指标为单次手术的视网膜复位率、再次手术情况、并发症发生率及视力(VA)变化。

结果

平均视力丧失时间为14.68±12.87天。17只眼(77.27%)存在黄斑脱离。所有眼中均顺利完成25G无缝合玻璃体切除术,无并发症发生。平均随访时间为10.40±5.77个月。21只眼(95.45%)单次手术实现视网膜复位,所有眼(100%)二次玻璃体切除术后均实现视网膜复位。末次随访时,平均术前视力1.61±1.18提高至0.50±0.53(P<0.001)。2只眼(9.09%)出现短暂性低眼压,自行缓解。未观察到其他术后并发症。

结论

25G无缝合玻璃体切除术联合斜行巩膜切口用于初次治疗非复杂性人工晶状体性RRD,单次手术视网膜复位率为95.45%,单眼再次手术复位率为100%,86%的患眼视力提高。

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