无缝 23 号与 20 号巩膜扣带术联合硅油注入治疗孔源性视网膜脱离。

Sutureless 23-gauge versus 20-gauge vitrectomy with silicone oil injection in rhegmatogenous retinal detachment.

机构信息

Smt. Kanuri Santhamma Vitreoretina Center, LV Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India.

出版信息

Retina. 2012 May;32(5):1013-6. doi: 10.1097/IAE.0b013e3182327cf9.

DOI:10.1097/IAE.0b013e3182327cf9

PMID:22366901

Abstract

PURPOSE

To report the efficacy of 23-gauge (G) pars plana vitrectomy with silicone oil injection in rhegmatogenous retinal detachment.

METHODS

Retrospective chart review of consecutive patients with retinal detachment who underwent pars plana vitrectomy by one of two surgeons using distinct and consistent methods. All patients undergoing 23-G pars plana vitrectomy did not have scleral buckling, whereas all patients undergoing surgery by 20-G pars plana vitrectomy had additional 240-band encircling scleral buckle. All patients received silicone oil tamponade. Patients with proliferative vitreoretinopathy Grade D, previous retinal detachment surgery, and penetrating eye injury were excluded. The main outcome measure was the final anatomical reattachment rate. The secondary outcome measures were the improvement in visual acuity and recurrence rate of retinal detachment after primary surgery.

RESULTS

Eighteen patients in the 23-G group and 21 patients in the 20-G group were analyzed. The mean age of the patients was 48.05 ± 10.37 years and 42.57 ± 17.84 years in the 23-G and 20-G groups, respectively. The mean follow-up duration was 5.9 months (range, 2-12 months) and 6.2 months (range, 4-9 months) in the 23-G and 20-G groups, respectively. The primary reattachment rate was 83.3% (95% confidence interval, 66.11%-100%) in the 23-G group and 86.8% (95% confidence interval, 67.81%-100%); P = 1.00) in 20-G group. The mean preoperative logarithm of the minimum angle of resolution visual acuity was 1.30 ± 0.57 (Snellen equivalent 20/400) in the 23-G group and 1.27 ± 0.70 (Snellen equivalent 20/400) in the 20-G group (P = 0.80). The mean logarithm of the minimum angle of resolution visual acuity at 1 month after the surgery was 0.66 ± 0.25 (Snellen equivalent 20/100) in the 23-G group and 0.77 ± 0.50 (Snellen equivalent 20/120; P = 0.46) in the 20-G group. The visual acuity at the last visit was 0.80 ± 0.52 (20/125) versus 0.65 ± 0.44 (20/100) in the 23-G and 20-G, respectively (P = 0.32).

CONCLUSION

Silicone oil injection with 23-G system is possible and is associated with favorable anatomical success in cases of rhegmatogenous retinal detachment.

摘要

目的

报告 23G 巩膜切开术联合硅油注气治疗孔源性视网膜脱离的疗效。

方法

对两位医生分别采用不同且一致的方法进行连续视网膜脱离患者的病例进行回顾性图表分析。所有接受 23G 巩膜切开术的患者均未行巩膜扣带术，而所有接受 20G 巩膜切开术的患者均行 240 带环绕巩膜扣带术。所有患者均接受硅油填充。排除患有增殖性玻璃体视网膜病变 D 级、既往视网膜脱离手术和穿透性眼外伤的患者。主要观察指标为最终解剖复位率。次要观察指标为原发性手术后视力提高和视网膜脱离复发率。

结果

23G 组 18 例患者和 20G 组 21 例患者被纳入分析。23G 组和 20G 组患者的平均年龄分别为 48.05 ± 10.37 岁和 42.57 ± 17.84 岁。23G 组和 20G 组的平均随访时间分别为 5.9 个月（范围：2-12 个月）和 6.2 个月（范围：4-9 个月）。23G 组的初次复位率为 83.3%（95%置信区间：66.11%-100%），20G 组为 86.8%（95%置信区间：67.81%-100%）；P=1.00）。23G 组术前最小分辨角对数视力均值为 1.30 ± 0.57（Snellen 等效值 20/400），20G 组为 1.27 ± 0.70（Snellen 等效值 20/400）；P=0.80）。23G 组术后 1 个月最小分辨角对数视力均值为 0.66 ± 0.25（Snellen 等效值 20/100），20G 组为 0.77 ± 0.50（Snellen 等效值 20/120）；P=0.46）。末次随访时 23G 组视力为 0.80 ± 0.52（20/125），20G 组为 0.65 ± 0.44（20/100）；P=0.32）。