Shiragami Chieko, Fukuda Kouki, Yamaji Hidetaka, Morita Misako, Shiraga Fumio
*Department of Ophthalmology, Kagawa University Faculty of Medicine, Kagawa, Japan; and †Department of Ophthalmology, Okayama University Medical School, Okayama, Japan.
Retina. 2015 Apr;35(4):758-63. doi: 10.1097/IAE.0000000000000383.
To investigate a method for preventing retinal slippage after standard vitrectomy for rhegmatogenous retinal detachment.
Eighty six eyes with bullous rhegmatogenous retinal detachment underwent successful standard vitrectomy. Patients were divided into 2 groups. In Group 1, 44 patients started face-down positioning at approximately 10 minutes after the end of the surgery. In Group 2, 42 patients started face-down positioning immediately at the end of the surgery. Postoperative retinal slippage was determined by fundus autofluorescence at 1 month postoperatively. Statistical analysis examined several factors to determine the association between the start time of the face-down positioning and retinal slippage.
Retinal slippage occurred in 63.6% of Group 1 and in 24.0% of Group 2 patients. This difference was statistically significant (P = 0.004, Fisher's exact probability test). Both the extent of retinal slippage (P = 0.029) and the face-down position (P < 0.001) were significantly associated with the retinal slippage.
Earlier implementation of face-down positioning may prevent retinal slippage after surgery in eyes with rhegmatogenous retinal detachment treated by standard vitrectomy.
探讨一种在孔源性视网膜脱离标准玻璃体切除术后预防视网膜脱离的方法。
86例大泡性孔源性视网膜脱离患者成功接受标准玻璃体切除术。患者分为2组。第1组44例患者在手术结束后约10分钟开始俯卧位。第2组42例患者在手术结束时立即开始俯卧位。术后1个月通过眼底自发荧光确定视网膜脱离情况。统计分析检查了几个因素,以确定俯卧位开始时间与视网膜脱离之间的关联。
第1组63.6%的患者发生视网膜脱离,第2组24.0%的患者发生视网膜脱离。这种差异具有统计学意义(P = 0.004,Fisher精确概率检验)。视网膜脱离程度(P = 0.029)和俯卧位(P < 0.001)均与视网膜脱离显著相关。
对于接受标准玻璃体切除术治疗的孔源性视网膜脱离患者,更早实施俯卧位可能预防术后视网膜脱离。