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12年期间气体视网膜固定术的治疗效果及并发症

Outcomes and complications of pneumatic retinopexy over a 12-year period.

作者信息

Modi Yasha S, Epstein Aliza, Flynn Harry W, Shi Wei, Smiddy William E

出版信息

Ophthalmic Surg Lasers Imaging Retina. 2014 Mar-Apr;45(2):132-7. doi: 10.3928/23258160-20140306-06.

Abstract

BACKGROUND AND OBJECTIVE

To evaluate anatomic and clinical outcomes of pneumatic retinopexy for treatment of primary retinal detachment.

PATIENTS AND METHODS

Noncomparative, single-center, consecutive, interventional case series evaluating all patients treated between 2000 and 2012. Patients with less than 1 month of follow-up or coexisting neovascular age-related macular degeneration, uveitis, endophthalmitis, or prior posterior segment surgery were excluded.

RESULTS

Sixty-three eyes of 63 patients with primary retinal detachment treated with pneumatic retinopexy were included. Median follow-up was 10.3 months. Single-operation success (SOS), defined as anatomic reattachment with pneumatic retinopexy alone, occurred in 40 eyes (63%). The retina was successfully reattached in 21 of the other 23 eyes (91%) with one additional surgery. There was no difference in visual acuity outcomes between SOS and additional surgical intervention (P = .85). New or missed breaks were identified in 19 of 63 eyes (30%). Postoperative subretinal fluid was observed in 22 of 63 eyes (35%) and persisted at last follow-up in two of 63 eyes (3%). At final follow-up, the retina was fully attached in 97% of eyes.

CONCLUSION

Pneumatic retinopexy remains a reasonably successful option in the management of primary retinal detachment. No difference in best corrected visual acuity outcomes in eyes achieving SOS versus those requiring additional surgery was demonstrated.

摘要

背景与目的

评估气体视网膜固定术治疗原发性视网膜脱离的解剖学及临床疗效。

患者与方法

一项非对比性、单中心、连续性、介入性病例系列研究,纳入2000年至2012年期间接受治疗的所有患者。排除随访时间少于1个月或合并存在新生血管性年龄相关性黄斑变性、葡萄膜炎、眼内炎或既往有后段手术史的患者。

结果

纳入63例接受气体视网膜固定术治疗的原发性视网膜脱离患者的63只眼。中位随访时间为10.3个月。单手术成功(SOS)定义为仅通过气体视网膜固定术实现解剖复位,40只眼(63%)达到该标准。另外23只眼中有21只眼(91%)经一次额外手术视网膜成功复位。SOS组与额外手术干预组的视力结果无差异(P = 0.85)。63只眼中有19只眼(30%)发现新的或遗漏的裂孔。63只眼中有22只眼(35%)观察到术后视网膜下液,63只眼中有2只眼(3%)在最后一次随访时仍存在视网膜下液。在最后一次随访时,97%的眼视网膜完全附着。

结论

气体视网膜固定术仍是原发性视网膜脱离治疗中一种相当成功的选择。实现SOS的眼与需要额外手术的眼在最佳矫正视力结果上无差异。

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