Vuković Dragan, Pajić Sanja Petrović, Paović Predrag
Srp Arh Celok Lek. 2014 Nov-Dec;142(11-12):717-20. doi: 10.2298/sarh1412717v.
Choroidal coloboma is a congenital defect caused by an inadequate closure of embryonic fissure. About 40% of the eyes with the choroidal coloboma (CHC) develop the retinal detachment (RD). It is extremely difficult to manage these cases due to the lack of pigmentation at the site of choroidal coloboma.
This is a case series of five patients with CHC and RD who were successfully operated using one of two different surgical techniques: pars plana vitrectomy (PPV)+silicone oil internal tamponade and/or scleral buckle with encircling band with laser photocoagulation (SB+EB+LPC) around the coloboma. The purpose of this paper is to present how to successfully handle patients with CHC, who have concurrent retinal detachment in the same eye and to compare two different techniques and indications for the predominant use of one of them in a specific case.
Both surgical techniques can be applied with equal success in the operation of retinal detachment in eyes with the chorioidal coloboma. Which one will be used depends only of the posterior segment of eye findings. We use scleral buckling in cases with RD accompanied by CHC when the peripheral break is evident and there are no breaks in the coloboma itself. We also perform, 2-3 days after surgery, laser burns around the coloboma, which is our modification of this technique. In all other cases it is indicated to perform PPV+silicon oil internal tamponade.
脉络膜缺损是一种由胚胎裂闭合不全引起的先天性缺陷。约40%患有脉络膜缺损(CHC)的眼睛会发生视网膜脱离(RD)。由于脉络膜缺损部位缺乏色素沉着,处理这些病例极其困难。
这是一组五例患有CHC和RD的患者的病例系列,他们通过两种不同手术技术之一成功接受了手术:玻璃体切除术(PPV)+硅油眼内填充和/或在缺损周围进行巩膜扣带术(SB)+环扎带术(EB)并联合激光光凝术(LPC)。本文的目的是介绍如何成功处理同一只眼睛同时患有CHC和视网膜脱离的患者,并比较两种不同技术以及在特定病例中主要使用其中一种技术的适应证。
两种手术技术在脉络膜缺损眼视网膜脱离手术中应用的成功率相同。使用哪种技术仅取决于眼后段的检查结果。当周边裂孔明显且缺损本身无裂孔时,对于伴有CHC的RD病例,我们采用巩膜扣带术。我们还在术后2至3天在缺损周围进行激光光凝,这是我们对该技术的改进。在所有其他情况下,建议进行PPV + 硅油眼内填充。