Department of Ophthalmology and Visual Sciences, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Department of Ophthalmology and Visual Sciences, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Can J Ophthalmol. 2014 Jun;49(3):256-60. doi: 10.1016/j.jcjo.2014.03.001.
To evaluate the outcome of vitrectomy using only original retinal breaks for subretinal fluid (SRF) drainage during the repair of primary rhegmatogenous retinal detachment (RRD).
A retrospective consecutive interventional case series.
A consecutive series of 112 eyes of 112 patients.
Patients underwent 23-gauge vitrectomy without the use of posterior retinotomy and perfluorocarbon liquids for uncomplicated primary RRD at Osaka City University Hospital between September 2007 and March 2011. Exclusion criteria included eyes with giant retinal tears, grade C2 or worse proliferative vitreoretinopathy (PVR), ocular trauma, and the presence of other vitreoretinal diseases.
Single-operation success rate was 92.9%, whereas final anatomical success rate was 100%. Median visual acuity improved significantly from the preoperative logMAR of 0.51 ± 0.78 to the postoperative logMAR of 0.03 ± 0.26 (p < 0.01). No significant differences were observed for the single-operation success rate between the 62 eyes (95.2%) in which some SRF remained at the end of the operation and the rest of the 50 eyes (90.0%, p = 1.000) in which the SRF had been completely aspirated. Complications included transient intraocular pressure rise (12 eyes, 10.7%), epiretinal membrane (5 eyes, 4.5%), and PVR (1 eye, 0.9%). Ocular hypotony and endophthalmitis were not observed.
Uncomplicated primary RRD can be successfully repaired by performing vitrectomy using only the original retinal breaks for SRF drainage. In addition, successful outcomes are not dependent on achieving complete reattachment of the retina throughout the fundus.
评估在原发性孔源性视网膜脱离（RRD）修复过程中仅使用原始视网膜裂孔进行视网膜下液（SRF）引流的玻璃体切除术的结果。
回顾性连续干预性病例系列。
112 例 112 只眼的连续病例系列。
2007 年 9 月至 2011 年 3 月，在大阪市立大学医院，对无复杂性原发性 RRD 的患者行 23G 玻璃体切除术，不使用后视网膜切开术和全氟化碳液体。排除标准包括巨大视网膜裂孔、C2 级或更高级别的增生性玻璃体视网膜病变（PVR）、眼外伤和其他玻璃体视网膜疾病。
单次手术成功率为 92.9%，最终解剖成功率为 100%。中位视力从术前对数视力 0.51 ± 0.78 显著提高到术后对数视力 0.03 ± 0.26（p<0.01）。在手术结束时仍有一些 SRF 存在的 62 只眼（95.2%）和 SRF 已完全吸出的其余 50 只眼（90.0%，p=1.000）之间，单次手术成功率无显著差异。并发症包括一过性眼压升高（12 只眼，10.7%）、视网膜内膜（5 只眼，4.5%）和 PVR（1 只眼，0.9%）。未观察到眼球压低和眼内炎。
仅使用原始视网膜裂孔进行 SRF 引流即可成功修复无复杂性原发性 RRD。此外，成功的结果并不依赖于整个眼底视网膜的完全复位。
