Smiddy W E, Flynn H W, Nicholson D H, Clarkson J G, Gass J D, Olsen K R, Feuer W
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Florida.
Am J Ophthalmol. 1991 Dec 15;112(6):623-31. doi: 10.1016/s0002-9394(14)77267-8.
One hundred sixty-four patients (171 eyes) were treated for retinal breaks and the treatment outcomes were studied. One hundred two eyes were acutely symptomatic, 22 eyes were chronically symptomatic, and 47 eyes were asymptomatic. The reasons for further treatment in 38 of the 171 eyes (22%) included the following: (1) inadequate closure of the original break without detachment in eight eyes (5%), (2) new breaks without detachment in 15 eyes (9%), (3) an operation for retinal detachment caused by the original break in seven eyes (4%), or (4) retinal detachment caused by a new break in eight eyes (5%). Failure rates of treatment among acutely symptomatic, chronically symptomatic, and asymptomatic subgroups were not statistically significant. The risk of treatment failure was higher for aphakic and pseudophakic eyes, and in eyes with peripheral retinal abnormalities in the fellow eye. Among 38 patients with failed treatments, 20 (52%) returned for further examination within one month of initial treatment, whereas eight of the 38 patients with failed treatments (21%) returned six months or more after initial treatment. Peripheral retinal abnormalities were recognized initially in 65 of the 171 fellow eyes (38%) and subsequently developed in nine of the fellow eyes (5%) during the follow-up interval. Further treatment is often necessary after initial treatment of peripheral retinal breaks, emphasizing the need for careful long-term follow-up care.
对164例患者（171只眼）进行了视网膜裂孔治疗，并对治疗结果进行了研究。其中102只眼有急性症状，22只眼有慢性症状，47只眼无症状。171只眼中38只眼（22%）需要进一步治疗的原因如下：（1）8只眼（5%）原裂孔封闭不全但未发生视网膜脱离；（2）15只眼（9%）出现新的裂孔但未发生视网膜脱离；（3）7只眼（4%）因原裂孔导致视网膜脱离而进行手术；或（4）8只眼（5%）因新裂孔导致视网膜脱离。急性症状组、慢性症状组和无症状亚组的治疗失败率无统计学差异。无晶状体眼和人工晶状体眼以及对侧眼有周边视网膜异常的眼治疗失败风险更高。在38例治疗失败的患者中，20例（52%）在初次治疗后1个月内返回进一步检查，而38例治疗失败的患者中有8例（21%）在初次治疗后6个月或更长时间返回。171只对侧眼中最初有65只眼（38%）发现周边视网膜异常，随访期间另外9只眼（5%）出现周边视网膜异常。周边视网膜裂孔初次治疗后通常需要进一步治疗，这强调了长期仔细随访的必要性。
