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用于原发性孔源性视网膜脱离初次修复的气体视网膜固定术。

Pneumatic retinopexy for primary repair of rhegmatogenous retinal detachments.

作者信息

Rahat Feisal, Nowroozzadeh Mohammad H, Rahimi Mansour, Farvardin Mohsen, Namati Ali J, Sarvestani Ali S, Sharifi Fatemeh

机构信息

*Department of Ophthalmology, Poostchi Eye Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; †Department of Ophthalmology, Poostchi Eye Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; and ‡Department of Ophthalmology, Dastghib Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Retina. 2015 Jun;35(6):1247-55. doi: 10.1097/IAE.0000000000000434.

Abstract

PURPOSE

To evaluate anatomical and functional outcomes of pneumatic retinopexy (PR) for primary repair of rhegmatogenous retinal detachments and to determine demographic and ocular risk factors for failure of the procedure.

DESIGN

Retrospective interventional case series.

METHODS

A chart review on 97 eyes of 97 consecutive patients who had undergone PR as the initial procedure for unilateral recent primary retinal detachments with causative break(s) in the superior two-third of the retina. After injection of 0.35 mL to 0.60 mL of sulfur hexafluoride, 6 hours face-down positioning, and the steamroller maneuver, the patient's head position was changed so that the gas could efficiently tamponade the retinal break(s). Pre- and post-gas injection laser photocoagulation of break(s) and 360° peripheral retina was applied.

RESULTS

Seventy-two male and 25 female patients were included in this study. The single-operation success rate was 82.5%. The pars plana vitrectomy procedure as the second intervention was not adversely affected by the preceding PR. Presence of proliferative vitreoretinopathy (odds ratio: 58.7, 95% confidence interval: 7.8-443.5) and delay between initial symptoms and PR (odds ratio: 1.21 per each additional day, 95% confidence interval: 1.07-1.37) were the only independent predictors for the failure.

CONCLUSION

With proper selection of cases, PR is a good surgical option for primary rhegmatogenous retinal detachments with acceptable success rate, minimal discomfort to the patient, and minimal surgical risks.

摘要

目的

评估气体视网膜固定术(PR)用于原发性孔源性视网膜脱离一期修复的解剖学和功能结果,并确定该手术失败的人口统计学和眼部危险因素。

设计

回顾性干预病例系列。

方法

对97例连续患者的97只眼进行图表回顾,这些患者接受PR作为单侧近期原发性视网膜脱离的初始手术,视网膜裂孔位于视网膜上三分之二。注入0.35 mL至0.60 mL六氟化硫,面部朝下定位6小时,并进行碾压操作后,改变患者头部位置,以便气体能有效压迫视网膜裂孔。对裂孔和360°周边视网膜进行气体注入前后的激光光凝。

结果

本研究纳入72例男性和25例女性患者。单次手术成功率为82.5%。作为二次干预的玻璃体切割术未受到先前PR的不利影响。增殖性玻璃体视网膜病变(优势比:58.7,95%置信区间:7.8 - 443.5)和初始症状与PR之间的延迟(每增加一天优势比:1.21,95%置信区间:1.07 - 1.37)是仅有的失败独立预测因素。

结论

通过适当选择病例,PR是原发性孔源性视网膜脱离的一种良好手术选择,成功率可接受,患者不适最小,手术风险最小。

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