Kim Yong-Kyu, Yoon Wontae, Ahn Jae Kyoun, Park Sung Pyo
Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
Jeonju Samsung Eye Clinic, Jeonju, Jeonrabuk-do, Republic of Korea.
J Ophthalmol. 2016;2016:4538193. doi: 10.1155/2016/4538193. Epub 2016 Sep 5.
Purpose. To evaluate the surgical outcome of scleral buckling (SB) in rhegmatogenous retinal detachment (RRD) patients associated with pars planitis. Methods. Retrospective review of RRD patients (32 eyes of pars planitis RRD and 180 eyes of primary RRD) who underwent SB. We compared primary and final anatomical success rates and visual outcomes between two groups. Results. Primary and final anatomical success were achieved in 25 (78.1%) and 31 (96.8%) eyes in the pars planitis RRD group and in 167 eyes (92.7%) and 176 eyes (97.7%) in primary RRD group, respectively. Both groups showed significant visual improvement (p < 0.001) and there were no significant differences in final visual acuity. Pars planitis RRD group was associated with higher rate of postoperative proliferative vitreoretinopathy (PVR) development (12.5% versus 2.8%, p = 0.031). Pars planitis and high myopia were significant preoperative risk factors and pseudophakia was borderline risk for primary anatomical failure after adjusting for various clinical factors. Conclusions. Pars planitis associated RRD showed inferior primary anatomical outcome after SB due to postoperative PVR development. However, final anatomical and visual outcomes were favorable. RRD cases associated with pars planitis, high myopia, and pseudophakia might benefit from different surgical approaches, such as combined vitrectomy and SB.
目的。评估巩膜扣带术(SB)治疗与中间葡萄膜炎相关的孔源性视网膜脱离(RRD)患者的手术效果。方法。对接受SB手术的RRD患者(32例中间葡萄膜炎性RRD患者的32只眼和180例原发性RRD患者的180只眼)进行回顾性研究。我们比较了两组的初次和最终解剖成功率以及视力结果。结果。中间葡萄膜炎性RRD组分别有25只眼(78.1%)和31只眼(96.8%)实现了初次和最终解剖成功,原发性RRD组分别有167只眼(92.7%)和176只眼(97.7%)实现了初次和最终解剖成功。两组均显示出显著的视力改善(p < 0.001),且最终视力无显著差异。中间葡萄膜炎性RRD组术后增殖性玻璃体视网膜病变(PVR)的发生率较高(12.5%对2.8%,p = 0.031)。在调整各种临床因素后,中间葡萄膜炎和高度近视是原发性解剖失败的重要术前危险因素,人工晶状体眼是临界危险因素。结论。由于术后PVR的发生,与中间葡萄膜炎相关的RRD在SB术后的初次解剖结果较差。然而,最终的解剖和视力结果良好。与中间葡萄膜炎、高度近视和人工晶状体眼相关的RRD病例可能受益于不同的手术方法,如玻璃体切除术联合SB。