Department of Ophthalmology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Am J Ophthalmol. 2013 Apr;155(4):750-6, 756.e1. doi: 10.1016/j.ajo.2012.11.002. Epub 2013 Jan 11.
To introduce a new approach for short-term external scleral buckling with pneumatic retinopexy for the management of rhegmatogenous retinal detachment with inferior retinal breaks.
Retrospective, noncomparative, interventional case series.
A review of 33 consecutive eyes of 31 patients who underwent external buckling with pneumatic retinopexy for uncomplicated rhegmatogenous retinal detachment with inferior retinal breaks from December 2006 through December 2010. An external buckle was made of a 505 sponge sutured along the blunt side of a 279 tyre (MIRA Inc). The buckle was inserted deeply into the inferior fornix without suture after pneumatic retinopexy and was kept in place for 3 days. Primary and final anatomic outcomes, visual acuity, and adverse events were recorded.
All patients tolerated the procedure. The mean follow-up period was 24.0 months (range, 9 to 61 months). Primary success, defined as successful retinal reattachment within 6 months without further treatment, was achieved in 29 (87.9%) eyes. All patients attained final retinal reattachment (100%). Overall, the mean best-corrected visual acuity improved significantly at the end of follow-up (0.30 logarithm of the minimal angle of resolution units; Snellen equivalent, 6/12), compared with the preoperative best-corrected visual acuity (0.82 logarithm of the minimal angle of resolution units; Snellen equivalent, 6/38; P < .001).
Short-term external buckling with pneumatic retinopexy is a novel and effective treatment for rhegmatogenous retinal detachment with inferior retinal breaks, with a comparable success rate with other treatment methods. This approach also can avoid complications of long-term buckle implantation. Further comparative cohort studies may be necessary to compare the clinical efficacy with other conventional operations.
介绍一种新的方法,即通过充气性视网膜固定术进行短期外部巩膜扣带术,以治疗伴有下方视网膜裂孔的孔源性视网膜脱离。
回顾性、非对照、干预性病例系列研究。
对 2006 年 12 月至 2010 年 12 月期间,31 例(33 只眼)单纯孔源性视网膜脱离伴有下方视网膜裂孔患者接受充气性视网膜固定术联合外部巩膜扣带术的情况进行回顾性分析。外部巩膜扣带由沿 279 轮胎钝侧缝合的 505 海绵制成(MIRA Inc)。充气性视网膜固定术后,将扣带深深地插入下穹窿,无需缝线,并保留 3 天。记录主要和最终的解剖学结果、视力和不良事件。
所有患者均能耐受该手术。平均随访时间为 24.0 个月(9 至 61 个月)。主要成功定义为 6 个月内无需进一步治疗即可成功视网膜复位。29 只眼(87.9%)达到主要成功。所有患者最终均实现视网膜复位(100%)。总体而言,与术前最佳矫正视力(0.82 最小分辨角对数单位;Snellen 等效视力,6/38)相比,随访结束时最佳矫正视力显著提高(0.30 最小分辨角对数单位;Snellen 等效视力,6/12;P <.001)。
充气性视网膜固定术联合短期外部巩膜扣带术是治疗伴有下方视网膜裂孔的孔源性视网膜脱离的一种新颖而有效的方法,其成功率与其他治疗方法相当。这种方法还可以避免长期扣带植入的并发症。可能需要进一步的比较队列研究来比较与其他传统手术的临床疗效。