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原发性视网膜脱离手术的趋势:一项双中心研究的结果。

Trends in primary retinal detachment surgery: results of a Bicenter study.

机构信息

Ludwig Boltzmann Institute of Retinology and Biomicroscopic Laser Surgery, Department of Ophthalmology, Rudolf Foundation Clinic, Vienna, Austria.

出版信息

Retina. 2011 May;31(5):928-36. doi: 10.1097/IAE.0b013e3181f2a2ad.

Abstract

PURPOSE

To assess trends and outcomes in retinal detachment (RD) surgery based on a retrospective, interventional, bicenter study.

METHODS

Baseline demographic data, surgical procedures, and outcomes from 230 patients with a diagnosis of primary rhegmatogenous RD, who underwent surgery between January 2007 and December 2008 at the Rudolf Foundation Clinic, Vienna (Center 1) and the Weill Cornell Medical College, New York, (Center 2) were analyzed using a regression model.

RESULTS

Besides the baseline parameters, lens status (P = 0.01), refraction (P = 0.01), retinal tears (P < 0.02), proliferative vitreoretinopathy (P = 0.02), and previous treatment (P < 0.02), the primary RD procedure (P < 0.0001) was significantly different between the 2 centers. In Center 1, scleral buckling was the most common primary RD procedure (66.19%) compared with vitrectomy (82.42%) in Center 2. Primary retinal reattachment (88.49% Center 1 vs. 84.62% Center 2, P = 0.43) and best-corrected visual acuity at the final follow-up (best-corrected visual acuity ≥ 0.3 logarithm of minimum angle of resolution 48.92% Center 1 vs. 47.25% Center 2, P = 0.78) were not significantly different between the 2 centers.

CONCLUSION

Although there is a trend toward primary vitrectomy, scleral buckling was preferred in the center in Vienna and primary vitrectomy in the center in New York. Despite the different primary RD procedures, anatomical and visual outcomes were comparable.

摘要

目的

基于回顾性、介入性、双中心研究评估视网膜脱离(RD)手术的趋势和结果。

方法

对 2007 年 1 月至 2008 年 12 月期间在维也纳 Rudolf 基金会诊所(中心 1)和纽约威尔康奈尔医学学院(中心 2)接受手术治疗的 230 例原发性孔源性 RD 患者的基线人口统计学数据、手术程序和结果进行分析,采用回归模型。

结果

除基线参数外,晶状体状态(P = 0.01)、屈光不正(P = 0.01)、视网膜裂孔(P < 0.02)、增殖性玻璃体视网膜病变(P = 0.02)和既往治疗(P < 0.02),2 个中心的主要 RD 手术方式(P < 0.0001)存在显著差异。在中心 1,巩膜扣带术是最常见的主要 RD 手术方式(66.19%),而在中心 2 则是玻璃体切除术(82.42%)。中心 1 视网膜复位(88.49%vs.中心 2 84.62%,P = 0.43)和最终随访时最佳矫正视力(最佳矫正视力≥0.3 对数最小分辨角视力 48.92%中心 1 vs. 47.25%中心 2,P = 0.78)差异无统计学意义。

结论

尽管存在向玻璃体切除术转变的趋势,但维也纳中心倾向于采用巩膜扣带术,而纽约中心则倾向于采用玻璃体切除术。尽管主要 RD 手术方式不同,但解剖学和视觉结果相当。

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