Ambler J S, Zegarra H, Meyers S M
Department of Ophthalmology, Cleveland Clinic Foundation, OH 44195-5024.
Retina. 1990;10(2):125-30. doi: 10.1097/00006982-199004000-00007.
In a consecutive series of 73 retinal detachments managed with pneumatic retinopexy, three (4.1%) of 73 eyes sustained chronic detachment of the posterior retina involving the macula even though all retinal breaks were closed. This shallow subretinal fluid persisted for 12 to 21 months but reabsorbed spontaneously. Two cases presented with a detached macula, one of which had pre-existing macular degeneration. The other case presented with an attached macula but it became detached immediately after pneumatic retinopexy. The visual acuities in the two patients who did not have macular pathology before the development of retinal detachment were 20/50 and 20/40 even with persistent subretinal fluid under the macula. In both cases the visual acuity improved to 20/30 after resolution of the subretinal fluid. Patients with a longstanding component to the retinal detachment and small retinal breaks may be at risk of developing chronic macular detachment following pneumatic retinopexy. Pockets of subretinal fluid can persist following scleral buckling, with or without drainage of subretinal fluid. However, it is unknown whether scleral buckling has a lower incidence of this complication than pneumatic retinopexy.
在连续73例采用气体视网膜固定术治疗的视网膜脱离病例中,73只眼中有3只(4.1%)出现累及黄斑的视网膜慢性脱离,尽管所有视网膜裂孔均已封闭。这种浅的视网膜下液持续了12至21个月,但随后自行吸收。2例患者初诊时黄斑脱离,其中1例存在黄斑变性。另1例初诊时黄斑未脱离,但气体视网膜固定术后立即出现脱离。视网膜脱离发生前无黄斑病变的2例患者,即使黄斑下存在持续的视网膜下液,视力仍分别为20/50和20/40。视网膜下液吸收后,2例患者的视力均提高到20/30。视网膜脱离病程较长且视网膜裂孔较小的患者,气体视网膜固定术后可能有发生慢性黄斑脱离的风险。巩膜扣带术后,无论是否引流视网膜下液,视网膜下液腔隙都可能持续存在。然而,巩膜扣带术这种并发症的发生率是否低于气体视网膜固定术尚不清楚。