Department of Ophthalmology, Istituto Clinico Humanitas, Rozzano, Milan, Italy.
Retina. 2011 Apr;31(4):686-91. doi: 10.1097/IAE.0b013e3181f0d249.
To compare the anatomical and functional outcomes of 23-gauge pars plana vitrectomy (PPV) with Densiron-68 tamponade and 360° endolaser versus 20-gauge PPV with encircling scleral buckling (ESB) and an SF6 gas tamponade for the repair of primary pseudophakic retinal detachment with inferior retinal breaks.
Prospective, randomized, comparative, interventional study. Eighty-two eyes of 82 consecutive patients were randomly assigned to 1 of the 2 treatment groups: 23-gauge PPV/Densiron-68 (44 eyes, 54%) or 20-gauge PPV/ESB/SF6 (20%) (38 eyes, 46%). The inclusion criterion was the presence of primary pseudophakic retinal detachment with at least 1 retinal break between the 4- and 8-o'clock positions. The study protocol involved a minimum of 7 visits: baseline, day of surgery, 1 week, and 1, 3, 6, and 9 months postoperation. Densiron-68 removal was performed within 12 weeks of the initial surgery. Two surgical procedures were required in the Densiron group to remove the oil.
After the primary procedure, the retina was reattached in 90% (40 of 44) of cases in the 23-gauge PPV/Densiron group and in 92% (35 of 38) of cases in the 20-gauge PPV/ESB/SF6 group (P = 0.2, Fisher's exact test). After resolution of redetachments, final anatomical success rate rose to 97% (43 of 44) in the 23-gauge PPV/Densiron group and 94% (36 of 38) in the 20-gauge PPV/SB/SF6 group (P = 0.32, Fisher's exact test). Mean final best-corrected visual acuity (logarithm of the minimum angle of resolution) was 0.40 in the 23-gauge PPV/Densiron group and 0.48 in the 20-gauge PPV/ESB/SF6 group (P = 0.31, t-test). Operative time was significantly less in the 23-gauge PPV/Densiron group (P = 0.002, t-test). No statistically significant difference in the complication rate between the two groups was recorded.
Twenty-three-gauge PPV combined with Densiron-68 and 360° endolaser and 20-gauge PPV combined with ESB/SF6 seemed to have similar efficacy in the repair of primary pseudophakic retinal detachment. Supplementary scleral buckling can be avoided using a Densiron-68 tamponade for retinal detachment with inferior retinal breaks.
比较 23 号auge 经睫状体平坦部玻璃体切除术（PPV）联合 densiron-68 填充和 360° 眼内激光光凝与 20 号auge 环扎加压巩膜外冷凝术联合 SF6 气体填充治疗下方视网膜裂孔性原发性孔源性视网膜脱离的解剖和功能结果。
前瞻性、随机、对照、干预性研究。82 例 82 只眼的连续患者被随机分为 2 个治疗组之一：23 号auge PPV/Densiron-68（44 只眼，54%）或 20 号auge PPV/ESB/SF6（20%）（38 只眼，46%）。纳入标准为存在至少 1 个位于 4 点至 8 点之间的视网膜裂孔的原发性孔源性白内障性视网膜脱离。研究方案包括至少 7 次就诊：基线、手术当天、1 周、1、3、6 和 9 个月。Densiron-68 在初次手术后 12 周内取出。在 densiron 组中，需要进行两次手术以去除油。
初次手术后，23 号auge PPV/Densiron 组中有 90%（40/44）的患者视网膜复位，20 号auge PPV/ESB/SF6 组中有 92%（35/38）的患者视网膜复位（P=0.2，Fisher 确切检验）。在解决复发性脱离后，23 号auge PPV/Densiron 组的最终解剖成功率上升至 97%（43/44），20 号auge PPV/ESB/SF6 组上升至 94%（36/38）（P=0.32，Fisher 确切检验）。23 号auge PPV/Densiron 组的最终最佳矫正视力（最小分辨角对数）平均为 0.40，20 号auge PPV/ESB/SF6 组为 0.48（P=0.31，t 检验）。23 号auge PPV/Densiron 组的手术时间明显短于 20 号auge PPV/ESB/SF6 组（P=0.002，t 检验）。两组的并发症发生率无统计学差异。
23 号auge PPV 联合 densiron-68 和 360° 眼内激光光凝与 20 号auge PPV 联合 ESB/SF6 似乎在修复原发性白内障性视网膜脱离方面具有相似的疗效。对于下方视网膜裂孔性视网膜脱离，使用 densiron-68 填充可避免补充巩膜外冷凝术。
