Orlin Anton, Hewing Nina J, Nissen Michael, Lee Sangwoo, Kiss Szilard, DʼAmico Donald J, Chan R V Paul
*Department of Ophthalmology, Weill Cornell Medical College, New York, New York; and †Department of Ophthalmology, Campus Benjamin Franklin, Charité - Universitaetsmedizin Berlin, Berlin, Germany.
Retina. 2014 Jun;34(6):1069-75. doi: 10.1097/IAE.0000000000000050.
To compare pars plana vitrectomy (PPV) with PPV combined with scleral buckle (PPV/SB) in the treatment of primary, noncomplex rhegmatogenous retinal detachment in an academic setting.
Retrospective review of 74 consecutive cases that underwent either PPV or PPV/SB for primary rhegmatogenous retinal detachment at New York Presbyterian Hospital, Weill Cornell Medical College. Fifty-two eyes underwent PPV alone while 22 eyes had PPV combined with SB. All eyes had a minimum of 2 months of follow-up. The main outcome measure was single surgery anatomical success.
Patients in the PPV/SB group were less likely to be phakic (P = 0.05) and more likely to have an inferior retinal break (P = 0.001) when compared with the PPV group. Between groups, there was no difference in eyes with peripheral retinal lattice degeneration (P = 0.929), multiple breaks (P = 0.801), breaks seen preoperatively (P = 0.095), or those presenting with the macula off retinal detachment (P = 0.548). The majority of patients in both groups underwent small-gauge surgery (23 G or 25 G) (P = 0.65). Attachment of the retina was obtained in 100% of the patients in both groups at most recent follow-up. Single surgery anatomical success was similar between groups (83% PPV vs. 86% PPV/SB; P = 0.695). Mean best-corrected Snellen visual acuity improved in both groups (P = 0.75), with a final best-corrected Snellen visual acuity of 0.418 logMAR in the PPV group and 0.479 logMAR in the PPV/SB group (P = 0.61). When comparing PPV with PPV/SB, no difference in single surgery anatomical success existed after evaluating eyes with inferior breaks (P = 0.68), pseudophakia (P = 0.75), or when small-gauge surgery was performed (P = 0.76).
We did not find significant differences in single surgery anatomical success, final anatomical success, or change in visual acuity when comparing PPV with PPV/SB in the repair of primary noncomplex rhegmatogenous retinal detachment in an academic setting where vitreoretinal fellows participate in key aspects of all cases.
在学术环境中比较玻璃体切割术（PPV）与玻璃体切割联合巩膜扣带术（PPV/SB）治疗原发性、非复杂性孔源性视网膜脱离的效果。
回顾性分析纽约长老会医院威尔康奈尔医学院连续74例因原发性孔源性视网膜脱离接受PPV或PPV/SB治疗的病例。52只眼仅接受PPV，22只眼接受PPV联合SB。所有患眼均至少随访2个月。主要观察指标为单次手术解剖学成功。
与PPV组相比，PPV/SB组患者晶状体眼的可能性较小（P = 0.05），下方视网膜裂孔的可能性较大（P = 0.001）。两组之间，周边视网膜格子样变性的患眼（P = 0.929）、多个裂孔的患眼（P = 0.801）、术前可见裂孔的患眼（P = 0.095）或黄斑脱离性视网膜脱离的患眼（P = 0.548）无差异。两组中的大多数患者接受了小切口手术（23G或25G）（P = 0.65）。在最近一次随访时，两组100%的患者视网膜均实现复位。两组单次手术解剖学成功率相似（PPV组为83%，PPV/SB组为86%；P = 0.695）。两组最佳矫正视力均有提高（P = 0.75），PPV组最终最佳矫正视力的LogMAR值为0.418，PPV/SB组为0.479（P =
