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小切口玻璃体切除术治疗视网膜脱离修复术后的视网膜前膜和黄斑囊样水肿

Epiretinal membrane and cystoid macular edema after retinal detachment repair with small-gauge pars plana vitrectomy.

作者信息

Banker Tanuj P, Reilly Gayatri S, Jalaj Sanjai, Weichel Eric D

机构信息

Department of Ophthalmology, Georgetown University Hospital, Washington, DC - USA.

Retina Group of Washington, Washington, DC - USA.

出版信息

Eur J Ophthalmol. 2015 Nov-Dec;25(6):565-70. doi: 10.5301/ejo.5000609. Epub 2015 Apr 15.

Abstract

PURPOSE

To evaluate the incidence rates of cystoid macular edema (CME) and epiretinal membrane (ERM) formation after uncomplicated primary 23-G and 25-G retinal detachment (RD) repair and to identify risk factors associated with postoperative CME and ERM formation.

METHODS

This was a consecutive interventional case series of 587 eyes that underwent one RD repair with 23-G or 25-G pars plana vitrectomy (PPV) with scleral buckling. Epiretinal membrane and CME were confirmed by optical coherence tomography (OCT) and fluorescein angiography (FA).

RESULTS

A total of 587 eyes with a mean follow-up of 404 days had incidence rates of 35.1% for ERM and 15.2% for CME. The incidence of ERM after combined PPV and scleral buckling (48.4%) (n = 61) was greater (p<0.0001) compared to that after PPV alone (31.2%) (n = 144).

CONCLUSIONS

Epiretinal membrane and CME develop frequently after small-gauge RD repair. Pars plana vitrectomy combined with scleral buckling is associated with a higher incidence of ERM. Patients might benefit from increased use of OCT and FA to help rule out CME/ERM.

摘要

目的

评估单纯性原发性23G和25G视网膜脱离(RD)修复术后黄斑囊样水肿(CME)和视网膜前膜(ERM)形成的发生率,并确定与术后CME和ERM形成相关的危险因素。

方法

这是一项连续性干预病例系列研究,纳入587只接受23G或25G玻璃体切割联合巩膜扣带术进行RD修复的患眼。通过光学相干断层扫描(OCT)和荧光素血管造影(FA)确诊ERM和CME。

结果

共587只患眼,平均随访404天,ERM发生率为35.1%,CME发生率为15.2%。玻璃体切割联合巩膜扣带术后ERM发生率(48.4%)(n = 61)高于单纯玻璃体切割术后(31.2%)(n = 144)(p<0.0001)。

结论

小切口RD修复术后ERM和CME发生率较高。玻璃体切割联合巩膜扣带术与较高的ERM发生率相关。增加OCT和FA的使用可能有助于患者排除CME/ERM。

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