Dayani Pouya N, Blinder Kevin J, Shah Gaurav K, Holekamp Nancy M, Joseph Daniel P, Wilson Bradley, Thomas Matthew A, Grand M Gilbert
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA.
Ophthalmic Surg Lasers Imaging. 2009 Nov-Dec;40(6):539-47. doi: 10.3928/15428877-20091030-02.
To compare the surgical outcome of scleral buckling (group 1) versus scleral buckling with pars plana vitrectomy (group 2) for the repair of macula-off rhegmatogenous retinal detachment without proliferative vitreoretinopathy.
A retrospective chart review was performed.
Eighty-three patients were identified in group 1 and 63 patients in group 2. Presenting visual acuity was 4/200 in group 1 and 3/200 in group 2. Median duration of detachment prior to surgery was 5 days in group 1 and 6 days in group 2. There was no statistical difference in best-corrected (P = .59) or most recent (P = .75) visual acuity between groups. Median best-corrected visual acuity was 20/30 and median most recent visual acuity was 20/40 in both groups. Significantly more additional procedures were performed in group 1 than in group 2 (21.7% vs 7.9%, respectively; P = .024). The final reattachment rate was 96.4% in group 1 and 98.4% in group 2. Proliferative vitreoretinopathy developed in 15.7% of patients in group 1 and 4.8% in group 2 (P= .037).
Visual outcome of scleral buckling is similar to scleral buckling with pars plana vitrectomy for the treatment of macula-off rhegmatogenous retinal detachment in patients without proliferative vitreoretinopathy. Patients undergoing scleral buckling only are at an increased risk of developing proliferative vitreoretinopathy and requiring additional procedures.
比较巩膜扣带术（第1组）与巩膜扣带联合玻璃体切割术（第2组）治疗无增生性玻璃体视网膜病变的黄斑脱离性孔源性视网膜脱离的手术效果。
进行回顾性病历审查。
第1组确定83例患者，第2组确定63例患者。第1组的初始视力为200分之4，第2组为200分之3。第1组手术前脱离的中位持续时间为5天，第2组为6天。两组之间最佳矫正视力（P = 0.59）或最近视力（P = 0.75）无统计学差异。两组的中位最佳矫正视力均为20/30，中位最近视力均为20/40。第1组比第组2进行的额外手术明显更多（分别为21.7%对7.9%；P = 0.024）。第1组的最终复位率为96.4%，第2组为98.4%。第1组15.7%的患者发生增生性玻璃体视网膜病变，第2组为4.8%（P = 0.037）。
对于治疗无增生性玻璃体视网膜病变的黄斑脱离性孔源性视网膜脱离，巩膜扣带术的视力结果与巩膜扣带联合玻璃体切割术相似。仅接受巩膜扣带术的患者发生增生性玻璃体视网膜病变和需要额外手术的风险增加。
