Oellers Patrick, Stinnett Sandra, Hahn Paul
Duke Eye Center, Duke University School of Medicine, Durham, NC, USA.
Clin Ophthalmol. 2016 May 30;10:1001-6. doi: 10.2147/OPTH.S104901. eCollection 2016.
Valved cannulas are a recent addition to small-gauge pars plana vitrectomy (PPV) and provide stable intraocular fluidics. The goal of this study was to compare outcomes and postoperative complication rates of valved vs nonvalved cannula small-gauge PPV for repair of retinal detachments (RDs) complicated by Grade C proliferative vitreoretinopathy (PVR).
A retrospective chart review of 364 consecutive eyes with either valved or nonvalved cannula PPV for RD repair was performed. The primary outcomes were single surgery and final anatomic success and change in best-corrected visual acuity for repair of RDs complicated by Grade C PVR.
We identified 36 eyes in the valved group and 31 eyes in the nonvalved group with Grade C PVR RD. The single surgery success was 83% vs 77% (P=0.555) and the final anatomic success was 94% vs 87% (P=0.404) in the valved vs nonvalved eyes, respectively. The mean final visual acuity gain was -0.36 logarithm of the minimum angle of resolution (logMAR; approximate Early Treatment Diabetes Retinopathy Study [ETDRS] score =17 letters) in valved eyes vs -0.33 logMAR (approximate ETDRS score =16 letters) in nonvalved eyes (P=0.81). Postoperative complication rates including postoperative day 1 hypotony, hypertony, and anterior chamber fibrin formation; postoperative retention of intraocular or subretinal perfluorocarbon liquid; and subsequent epiretinal membrane peel were not statistically different between groups.
Valved cannula PPV yields equivalent visual acuity and anatomic outcomes without increased postoperative complication rates compared to traditional nonvalved cannula PPV for Grade C PVR-associated RD repair.
带瓣套管是近期应用于小切口玻璃体切割术（PPV）的器械，可提供稳定的眼内液流。本研究的目的是比较带瓣与不带瓣套管小切口PPV修复合并C级增生性玻璃体视网膜病变（PVR）的视网膜脱离（RD）的手术效果和术后并发症发生率。
对364例连续行带瓣或不带瓣套管PPV修复RD的患者进行回顾性病历分析。主要观察指标为单次手术及最终解剖复位成功情况，以及修复合并C级PVR的RD后最佳矫正视力的变化。
我们确定带瓣组有36只眼，不带瓣组有31只眼合并C级PVR RD。带瓣眼与不带瓣眼的单次手术成功率分别为83%和77%（P = 0.555），最终解剖复位成功率分别为94%和87%（P = 0.404）。带瓣眼平均最终视力提高-0.36最小分辨角对数（logMAR；近似早期糖尿病视网膜病变研究[ETDRS]评分 = 17个字母），不带瓣眼为-0.33 logMAR（近似ETDRS评分 = 16个字母）（P = 0.81）。术后并发症发生率，包括术后第1天的低眼压、高眼压和前房纤维蛋白形成；眼内或视网膜下全氟碳液体残留；以及随后的视网膜前膜剥除，两组间无统计学差异。
与传统不带瓣套管PPV修复合并C级PVR的RD相比，带瓣套管PPV在视力和解剖学效果方面相当，且术后并发症发生率并未增加。
