Mikhail Mikel, Ali-Ridha Andre, Chorfi Sarah, Kapusta Michael A
Department of Ophthalmology, Jewish General Hospital, McGill University, 3755 Côte-Ste-Catherine Road, Montreal, Québec, H3T1E2, Canada.
Department of Ophthalmology, Université de Montréal, Montreal, QC, Canada.
Graefes Arch Clin Exp Ophthalmol. 2017 Feb;255(2):255-261. doi: 10.1007/s00417-016-3442-7. Epub 2016 Aug 2.
To evaluate the short- and long-term surgical and clinical outcomes in eyes with diabetic tractional retinal detachment (TRD) undergoing 25-G+ pars-plana vitrectomy (PPV).
A total of 238 patients were reviewed for inclusion in this study. A retrospective cohort study of 109 eyes of 73 patients operated on for diabetic TRD were included. All eyes received intraocular tamponade of air, sulfur hexafluoride, octofluropropane or silicone oil. All patients were followed up for a minimum period of one year.
The mean age of all patients at surgery was 53.9 years ± 9.2, while the mean duration of diabetes was 18.7 ± 10.4 years. The mean length of follow-up was 923 ± 87 days after surgery (range, 432-1792 days). Thirty-two cases (29.3 %) had an associated rhegmatogenous component. Mean BCVA improved from logarithm minimum angle of resolution (logMAR) 1.17 (20/300) to 0.812 (20/130) (p < 0.05). All eyes underwent intraoperative laser photocoagulation. Primary, single-surgery anatomic reattachment was achieved in 99 eyes (91 %). Final anatomic attachment was achieved in 107 eyes (98 %). There was no statistically significant difference in primary or secondary re-attachment rate in terms of type of tamponade agent used. There were five cases of post-operative hypotony (≤5 mmHg) on postoperative day 1, while 11 eyes had IOP ≥ 30 mmHg. There were no cases of endophthalmitis in our cohort.
25G+ PPV provides for safe and effective repair of diabetic TRDs. Patients experienced positive functional and anatomic outcomes, with no significant intraoperative complications and minimal postoperative sequelae.
评估接受25G+玻璃体切割术（PPV）治疗的糖尿病性牵拉性视网膜脱离（TRD）患者的短期和长期手术及临床疗效。
共纳入238例患者进行本研究评估。回顾性队列研究纳入了73例因糖尿病性TRD接受手术的患者的109只眼。所有患眼均接受了空气、六氟化硫、八氟丙烷或硅油的眼内填充。所有患者均接受了至少一年的随访。
所有患者手术时的平均年龄为53.9岁±9.2岁，糖尿病平均病程为18.7±10.4年。术后平均随访时间为923±87天（范围432 - 1792天）。32例（29.3%）伴有孔源性成分。平均最佳矫正视力（BCVA）从最小分辨角对数（logMAR）1.17（20/300）提高到0.812（20/130）（p < 0.05）。所有患眼均接受了术中激光光凝。99只眼（91%）实现了初次单手术解剖复位。107只眼（98%）实现了最终解剖复位。就所用填充剂类型而言，初次或二次复位率无统计学显著差异。术后第1天有5例出现低眼压（≤5 mmHg），11只眼眼压≥30 mmHg。本队列中无眼内炎病例。
25G+PPV为糖尿病性TRD提供了安全有效的修复方法。患者在功能和解剖方面均取得了良好效果，术中无明显并发症，术后后遗症极少。
