Department of Ophthalmology, University of Amsterdam, The Netherlands.
Retina. 2009 Oct;29(9):1299-1304. doi: 10.1097/IAE.0b013e3181aa0f5f.
To evaluate the anatomical and functional results of 25-gauge transconjuctival vitrectomy in the management of primary rhegmatogenous retinal detachment (RRD).
A retrospective, noncomparative interventional case series including 131 consecutive patients who underwent 25-gauge transconjunctival vitrectomy for primary RRD repair was performed. Data concerning pre- and postoperative visual acuity and intraocular pressure (IOP), lens status, macular status, location of primary break, surgical time, postoperative inflammation, peri- and postoperative complications, and number of sutured sites were collected. Main outcome measures were anatomical success rate, postoperative visual acuity and IOP, and peri- and postoperative complications.
The success rate at 3 months was 92.4%. The visual acuity improved from 20/50 (range, 20/16 to light perception) to 20/32 (range, 20/200 to 20/16). Ten patients (7.6%) redetached after a mean follow-up time of 38 days (range, 21-53 days) because of the presence of proliferative vitreoretinopathy in 7 eyes (9.2%) or a new retinal tear in 3 eyes (3.9%). A lowered IOP between 6 mmHg and 10 mmHg (mean, 7.8 mmHg) was observed in 11 patients (8.4%). None had frank hypotony. None of the patients had choroidal detachment or endophthalmitis.
Good case selection was shown to ensure good outcomes with 25-gauge transconjuctival vitrectomy in the management of primary RRD.
评估 25G 经结膜玻璃体切除术治疗原发性孔源性视网膜脱离（RRD）的解剖和功能结果。
进行了一项回顾性、非对照的干预性病例系列研究，纳入了 131 例连续接受 25G 经结膜玻璃体切除术治疗原发性 RRD 修复的患者。收集了术前和术后视力和眼压（IOP）、晶状体状态、黄斑状态、初级裂孔位置、手术时间、术后炎症、围手术期和术后并发症以及缝合部位数量等数据。主要观察指标为解剖成功率、术后视力和 IOP 以及围手术期并发症。
3 个月时的成功率为 92.4%。视力从 20/50（范围，20/16 至光感）提高到 20/32（范围，20/200 至 20/16）。10 例患者（7.6%）在平均 38 天（范围，21-53 天）的随访中再次脱离，原因是 7 只眼（9.2%）出现增生性玻璃体视网膜病变或 3 只眼（3.9%）出现新的视网膜裂孔。11 例患者（8.4%）眼压在 6mmHg 至 10mmHg 之间下降（平均 7.8mmHg）。无明显低眼压。无患者发生脉络膜脱离或眼内炎。
良好的病例选择确保了 25G 经结膜玻璃体切除术治疗原发性 RRD 的良好效果。
