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不使用重液的原发性玻璃体切除术治疗孔源性视网膜脱离

[Primary vitrectomy for rhegmatogenous retinal detachment without use of heavy liquids].

作者信息

Neuhann I, Bartz-Schmidt K-U

机构信息

MVZ Prof. Neuhann, München.

出版信息

Klin Monbl Augenheilkd. 2013 Oct;230(10):1025-8. doi: 10.1055/s-0032-1328620. Epub 2013 Jul 10.

DOI:10.1055/s-0032-1328620
PMID:23842871
Abstract

PURPOSE

The purpose of this study was to analyse the outcome of vitrectomy for rhegmatogenous retinal detachment without intraoperative use of heavy perfluorocarbon liquids (PFCL).

MATERIAL AND METHODS

All patients who had undergone vitrectomy with a PFCL-free approach during 4/2001-3/2008 by one single surgeon were recruited retrospectively from the electronic database and their data analysed.

RESULTS

A total of 79 patients (42 pseudophakic, 37 phakic) with unilateral surgery were included in the study. The median follow-up was 20.5 months (minimum 3, maximum 133). Median preoperative best-corrected visual acuity was 0.5 logMAR (minimum 0, maximum 2.5) as compared to a postoperative median of 0.45 logMAR (minimum - 0.2, maximum 1.3). The primary anatomic success rate (portion of patients not requiring further retinal surgery, including macular pucker or macular hole surgery) was 70 % for the phakic group, 71 % for the pseudophakic group, and 71 % for all cases. The redetachment rate was 19 % for all cases. The final reattachment rate was 100 %. Complications requiring a repeat surgical intervention occurred in 23 cases, including 7 patients (9 %) with proliferative vitreoretinopathy, and 4 patients (5 %) with macular pucker and macular hole each.

CONCLUSION

Even though this surgical procedure avoids possible disadvantages of retained intraocular PFCL and may be more cost-effective, the potential benefits do not outweigh the reduced primary anatomic success rate. The authors therefore recommend this approach in selected cases only.

摘要

目的

本研究旨在分析在术中不使用重质全氟碳液体(PFCL)的情况下,玻璃体切除术治疗孔源性视网膜脱离的效果。

材料与方法

从电子数据库中回顾性招募了2001年4月至2008年3月期间由同一位外科医生采用无PFCL方法进行玻璃体切除术的所有患者,并对其数据进行分析。

结果

本研究共纳入79例接受单侧手术的患者(42例人工晶状体眼,37例晶状体眼)。中位随访时间为20.5个月(最短3个月,最长133个月)。术前最佳矫正视力中位数为0.5 logMAR(最低0,最高2.5),术后中位数为0.45 logMAR(最低-0.2,最高1.3)。晶状体眼组的主要解剖成功率(无需进一步视网膜手术的患者比例,包括黄斑皱襞或黄斑裂孔手术)为70%,人工晶状体眼组为71%,所有病例为71%。所有病例的再脱离率为19%。最终复位率为100%。23例患者发生了需要再次手术干预的并发症,包括7例(9%)增生性玻璃体视网膜病变患者,以及4例(5%)黄斑皱襞和黄斑裂孔患者。

结论

尽管该手术方法避免了眼内残留PFCL可能带来的缺点,且可能更具成本效益,但潜在益处并未超过降低的主要解剖成功率。因此,作者仅建议在特定病例中采用这种方法。

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