Sato Tatsuhiko, Emi Kazuyuki, Bando Hajime, Ikeda Toshihide
Osaka Rosai Hospital Clinical Research Center for Occupational Sensory Organ Disability, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan,
Graefes Arch Clin Exp Ophthalmol. 2014 Dec;252(12):1895-902. doi: 10.1007/s00417-014-2846-5. Epub 2014 Nov 7.
The purpose of the study was to compare the outcomes of 25-gauge vitrectomy for the repair of rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy (PVR) with and without anterior PVR (A-PVR).
We reviewed the medical records of 26 eyes of 26 patients who underwent 25-gauge vitrectomy for grade C PVR with A-PVR and 16 eyes of 16 patients who underwent the same procedure for grade C PVR without A-PVR.
The number of previous surgeries for RRD was significantly higher in A-PVR cases than in those without A-PVR (P = 0.021). Scleral buckling and retinotomy/retinectomy were performed significantly more frequently in A-PVR eyes than in those without A-PVR (P = 0.017 and <0.001, respectively). The A-PVR eyes required longer surgical times than those without A-PVR (P =0.001). Final anatomical success was achieved in 24 of 26 (92.3 %) eyes with A-PVR and 16 of 16 (100 %) eyes without A-PVR (P =0.517). Best-corrected visual acuity before and six months after vitrectomy was 1.41 ± 0.96 and 0.86 ± 0.78 logarithm of minimal angle of resolution (logMAR) units, respectively, in eyes with A-PVR and 1.17 ± 0.87 and 0.63 ± 0.72 logMAR units, respectively, in eyes without A-PVR (P =0.355 and 0.276, respectively).
These results indicate that 25-gauge vitrectomy can be used for both types of PVR, although eyes with A-PVR may require scleral buckling and retinotomy/retinectomy more often and may require longer surgical times.
本研究旨在比较25G玻璃体切除术治疗合并或不合并前部增殖性玻璃体视网膜病变(A-PVR)的孔源性视网膜脱离(RRD)并发增殖性玻璃体视网膜病变(PVR)的疗效。
我们回顾了26例接受25G玻璃体切除术治疗合并A-PVR的C级PVR患者的26只眼,以及16例接受相同手术治疗不合并A-PVR的C级PVR患者的16只眼的病历。
RRD既往手术次数在合并A-PVR的病例中显著高于不合并A-PVR的病例(P = 0.021)。巩膜扣带术和视网膜切开术/视网膜切除术在合并A-PVR的眼中的实施频率显著高于不合并A-PVR的眼(分别为P = 0.017和<0.001)。合并A-PVR的眼比不合并A-PVR的眼需要更长的手术时间(P = 0.001)。26只合并A-PVR的眼中有24只(92.3%)最终获得解剖学成功,16只不合并A-PVR的眼中有16只(100%)获得成功(P = 0.517)。合并A-PVR的眼玻璃体切除术前和术后6个月的最佳矫正视力分别为1.41±0.96和0.86±0.78最小分辨角对数(logMAR)单位,不合并A-PVR的眼分别为1.17±0.87和0.63±0.72 logMAR单位(分别为P = 0.355和0.276)。
这些结果表明,25G玻璃体切除术可用于两种类型的PVR,尽管合并A-PVR的眼可能更常需要巩膜扣带术和视网膜切开术/视网膜切除术,且可能需要更长的手术时间。