Vingolo Enzo Maria, Nebbioso Marcella, Domanico Daniela, Valente Stefano, Frati Paola
Dipartimento di Oftalmologia, Sapienza Università di Roma, Polo Pontino, Ospedale "A. Fiorini", Terracina (LT), Italy.
Ann Ist Super Sanita. 2013;49(4):336-9. doi: 10.4415/ANN_13_04_03.
To evaluate relationships between the incidence of re-detachment and postoperative days of hospitalization in patients with diagnosis of retinal detachment (RD) who underwent surgery either through ab-externo approach (scleral buckling and encircling) or ab-interno approach (vitrectomy and oil-gas tamponade).
This retrospective study included 268 patients (268 eyes) with diagnosis of primary RD: 127 males (47%) and 141 (53%) females, mean age of 64.1 ± 17.3 years. 46 patients (17%) underwent a surgical ab-externo approach (group A), while 222 patients (83%) underwent an ab-interno surgical approach. Each RD was graded according to the "Retinal detachment grading system of Royal College of Ophthalmologists" and treated within 5 days after diagnosis. The redetachment (RT) related to a surgical failure was considered within 30 days after first operation.
In the group 1 without night hospitalization (day surgery) global RT rate was 3.5% (4.17% for ab-interno technique and 0% for ab-externo techniques). In the group 2 with one day of hospitalization global RT rate was 1.33% (1.49% for ab-interno technique and 0% for ab-externo techniques). In the group 3 with 2 days of hospitalization global RT rate was 3.80% (4.62% for ab-interno techniques and 0% for ab-externo techniques). In the group 4 with 3 or more days of hospitalization global RT rate was 12.28% (14.29% for ab-interno techniques for 6.67% ab-externo techniques). The incidence of RT in group 1, day surgery, is comparable to the other groups and it is less compared to group 4 (3 or more days of hospitalization).
The incidence of retinal redetachment (RRD) is not increased in day surgery mode. These data support outpatient management of RD patients to reduce medical cost and problems related to the hospitalization. Further studies are needed for patients' security.
评估采用外路手术（巩膜扣带术和环扎术）或内路手术（玻璃体切除术和硅油-气体填塞术）治疗的视网膜脱离（RD）患者再脱离发生率与术后住院天数之间的关系。
这项回顾性研究纳入了268例诊断为原发性RD的患者（268只眼）：男性127例（47%），女性141例（53%），平均年龄64.1±17.3岁。46例患者（17%）接受了外路手术（A组），而222例患者（83%）接受了内路手术。根据“皇家眼科医学院视网膜脱离分级系统”对每例RD进行分级，并在诊断后5天内进行治疗。首次手术后30天内发生的与手术失败相关的再脱离（RT）被纳入研究。
在第1组非夜间住院（日间手术）患者中，总体RT率为3.5%（内路技术为4.17%，外路技术为0%）。在第2组住院1天的患者中，总体RT率为1.33%（内路技术为1.49%，外路技术为0%）。在第3组住院2天的患者中，总体RT率为3.80%（内路技术为4.62%，外路技术为0%）。在第4组住院3天或更长时间的患者中，总体RT率为12.28%（内路技术为14.29%，外路技术为6.67%）。第1组日间手术患者的RT发生率与其他组相当，且低于第4组（住院3天或更长时间）。
日间手术模式下视网膜再脱离（RRD）的发生率并未增加。这些数据支持对RD患者进行门诊管理，以降低医疗成本和与住院相关的问题。为确保患者安全，还需要进一步研究。
