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玻璃体视网膜手术联合气体填充治疗孔源性视网膜脱离后严格俯卧位与可调节体位的比较。

A comparison of strict face-down positioning with adjustable positioning after pars plana vitrectomy and gas tamponade for rhegmatogenous retinal detachment.

作者信息

Chen Xiao, Yan Ying, Hong Ling, Zhu Li

机构信息

Department of Ophthalmology, Wuhan General Hospital of Guangzhou Command, Wuhan, China.

出版信息

Retina. 2015 May;35(5):892-8. doi: 10.1097/IAE.0000000000000413.

Abstract

PURPOSE

To compare face-down positioning and adjustable positioning after pars plana vitrectomy for the repair of rhegmatogenous retinal detachment.

METHODS

Sixty-eight eyes from 68 patients with rhegmatogenous retinal detachment were included in this study. All patients received pars plana vitrectomy with long-acting gas for tamponade and then subdivided into 2 groups: 29 were included in a face-down group and 39 were included in the adjustable positioning group. Patients were followed up for 3 months. The main outcome was the rate of anatomical retinal reattachment. Secondary outcome measures were best-corrected visual acuity and postoperative complications.

RESULTS

Most of the preoperative baseline characteristics between the two groups were not significantly different. The anatomical success rates after primary surgery were 89.7% and 92.3% for the face-down group and the adjustable positioning group, respectively (P = 1.00). Best-corrected visual acuity at the 3-month postoperative visit was 0.74 ± 0.25 for the face-down group and 0.77 ± 0.36 for the adjustable positioning group, respectively (P = 0.41). The rates of complications were not statistically different in the two groups.

CONCLUSION

Adjustable positioning after pars plana vitrectomy and gas tamponade for rhegmatogenous retinal detachment repair is effective and safe. Face-down positioning seems not to be necessary for all patients with rhegmatogenous retinal detachment.

摘要

目的

比较玻璃体切割术后面朝下体位与可调节体位在孔源性视网膜脱离修复中的应用效果。

方法

本研究纳入68例孔源性视网膜脱离患者的68只眼。所有患者均接受玻璃体切割联合长效气体填充术,随后分为两组:面朝下体位组29例,可调节体位组39例。对患者进行3个月的随访。主要观察指标为视网膜解剖复位率。次要观察指标为最佳矫正视力和术后并发症。

结果

两组术前的大多数基线特征无显著差异。面朝下体位组和可调节体位组初次手术后的解剖成功率分别为89.7%和92.3%(P = 1.00)。术后3个月随访时,面朝下体位组的最佳矫正视力为0.74±0.25,可调节体位组为0.77±0.36(P = 0.41)。两组并发症发生率无统计学差异。

结论

玻璃体切割联合气体填充修复孔源性视网膜脱离后采用可调节体位是有效且安全的。并非所有孔源性视网膜脱离患者都需要采用面朝下体位。

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