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25G玻璃体切割术治疗伴有或不伴有前部增殖的增生性玻璃体视网膜病变的回顾性比较

Retrospective comparison of 25-gauge vitrectomy for repair of proliferative vitreoretinopathy with or without anterior proliferation.

作者信息

Sato Tatsuhiko, Emi Kazuyuki, Bando Hajime, Ikeda Toshihide

机构信息

Osaka Rosai Hospital Clinical Research Center for Occupational Sensory Organ Disability, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan,

出版信息

Graefes Arch Clin Exp Ophthalmol. 2014 Dec;252(12):1895-902. doi: 10.1007/s00417-014-2846-5. Epub 2014 Nov 7.

Abstract

PURPOSE

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).

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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