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环形带、激光视网膜固定术和晶状体切除作为复杂视网膜脱离的标准手术程序,显示出良好的临床效果。

Encircling band, laser retinopexy and lens removal as standard procedure in complicated retinal detachment shows a good clinical outcome.

机构信息

Department of Ophthalmology, Medical University of Graz, Graz, Austria.

出版信息

Acta Ophthalmol. 2011 Nov;89(7):629-33. doi: 10.1111/j.1755-3768.2009.01763.x. Epub 2010 Feb 12.

Abstract

PURPOSE

To evaluate vitrectomy in conjunction with the use of perfluorocarbon, cerclage, laser retinopexy, lens removal and silicone oil as surgical treatment of proliferative vitreoretinopathy associated with retinal detachment.

METHODS

Sixty-two eyes of 62 patients were treated for complicated retinal detachment following failed prior scleral buckling. Outcome measures were; retinal reattachment rate 6 months after silicone oil removal, status of the retina, visual acuity (VA), duration of silicone tamponade and frequency of reoperations.

RESULTS

The final reattachment rate was 95%. Reoperations had to be performed in 25% of patients. Eighty-one per cent of these patients received one and 19% two or more operations following silicone oil implantation. The mean time to reoperation was 1.8 ± 1.4 months. Silicone oil was removed after 5.6 ± 4.1 months following the last vitreoretinal procedure in 90%, respectively, 95% with attached retina. Five per cent experienced retinal detachment after silicone oil removal. At the end of follow-up, the mean VA was 0.13 ± 0.26 Snellen. Seventy per cent of patients achieved a vision of 20/200 or better (mean 0.25 ± 0.27).

CONCLUSION

Our study demonstrates good final outcomes when a rigorous surgical approach was used. Furthermore, this standard procedure reduces the need for reoperations and consequently improves the functional outcome.

摘要

目的

评估玻璃体切除术联合使用全氟碳、环扎、激光视网膜光凝、晶状体切除和硅油作为治疗伴有视网膜脱离的增殖性玻璃体视网膜病变的手术治疗方法。

方法

62 例 62 只眼在巩膜扣带术失败后,因复杂性视网膜脱离接受了治疗。术后 6 个月的视网膜复位率、视网膜状态、视力(VA)、硅油填充时间和再手术频率是主要的观察指标。

结果

最终视网膜复位率为 95%。25%的患者需要再次手术。其中 81%的患者在硅油植入后进行了一次手术,19%的患者进行了两次或更多次手术。再次手术的平均时间为 1.8±1.4 个月。90%的患者在最后一次玻璃体视网膜手术后 5.6±4.1 个月取出硅油,95%的患者视网膜附着。5%的患者在硅油取出后出现视网膜脱离。随访结束时,平均 VA 为 0.13±0.26 Snellen。70%的患者视力达到 20/200 或更好(平均 0.25±0.27)。

结论

当采用严格的手术方法时,我们的研究显示出良好的最终结果。此外,这种标准程序减少了再次手术的需要,从而改善了功能结果。

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