Department of Ophthalmology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Retina. 2013 Jan;33(1):105-10. doi: 10.1097/IAE.0b013e318263ceca.
To determine if same-day or next available surgery changed the outcome of patients presenting with acute macula-on rhegmatogenous retinal detachments.
A retrospective review of patients presenting with acute macula-on rhegmatogenous retinal detachments treated with small-gauge vitrectomy was performed. Data collection included subjects' demographics, duration of symptoms, location and extent of the retinal detachment, and timing of surgery. The primary outcome was anatomical and functional success rate for patients having same-day surgery compared with those for whom surgery was delayed.
One hundred and fourteen patients were included in this study. Sixty-two patients operated on day of presentation, 46 patients operated the day after presentation, and in 6 patients, surgery was delayed from 2 to 5 days. Time to surgery in hours ranged between 1 and 120 hours (mean 14.5 ± 15.05 hours). Retinal reattachment was achieved in 95.6% of patients, with 80% requiring only one procedure. Mean initial visual acuity was logarithm of the minimum angle of resolution 0.42 (SD 0.6), and mean final visual acuity was logarithm of the minimum angle of resolution 0.39 (SD 0.67) (P = 0.53). Time to surgery was not found to effect final anatomical outcome (P = 0.56). No statistically significant association was observed between change in visual acuity and time to surgery (P = 0.99).
Modest delay in timing of surgery for macula-on rhegmatogenous retinal detachment did not adversely impact on patients' outcome.
确定当天或次日手术是否改变了急性黄斑裂孔性视网膜脱离患者的治疗效果。
对接受小口径玻璃体切割术治疗的急性黄斑裂孔性视网膜脱离患者进行回顾性研究。数据收集包括患者的人口统计学资料、症状持续时间、视网膜脱离的位置和范围以及手术时间。主要结局是比较当天手术和延迟手术的患者的解剖学和功能成功率。
本研究共纳入 114 例患者。62 例患者在就诊当天接受手术，46 例患者在就诊次日接受手术，6 例患者的手术时间延迟了 2 至 5 天。手术时间在 1 至 120 小时之间（平均 14.5 ± 15.05 小时）。95.6%的患者视网膜复位成功，其中 80%的患者只需进行一次手术。初始平均视力对数最小分辨角为 0.42（标准差 0.6），最终平均视力对数最小分辨角为 0.39（标准差 0.67）（P=0.53）。手术时间未发现对最终解剖学结果有影响（P=0.56）。视力变化与手术时间之间也没有观察到统计学上的显著关联（P=0.99）。
对于黄斑裂孔性视网膜脱离患者，适度延迟手术时间不会对患者的预后产生不利影响。
