Lumi Xhevat, Lužnik Zala, Petrovski Goran, Petrovski Beáta Éva, Hawlina Marko
Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000, Ljubljana, Slovenia.
Department of Ophthalmology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Korányi fasor 10-11, 6720, Szeged, Hungary.
BMC Ophthalmol. 2016 Dec 9;16(1):216. doi: 10.1186/s12886-016-0390-2.
Pars plana vitrectomy (PPV) is preferred surgical procedure for the management of complex rhegmatogenous retinal detachment (RRD). The purpose of this study was to evaluate the anatomical results of primary PPV for the treatment of primary complex RRD and to determine the influence of lens status, tamponading agent, preoperative proliferative vitreoretinopathy (PVR) and axial length (AL) of the eye upon the anatomical outcome.
A retrospective consecutive chart analysis was performed on 117 eyes from 117 patients with complex RRD managed with PPV. Fifty-nine eyes were phakic and 58 pseudophakic eyes. All patients had a minimum follow-up period of 12 months. Eyes were classified into groups using independent variables (first classification based upon lens status and tamponade used, second classification based upon lens and PVR status and third classification based upon AL of the eye). The groups were compared for anatomical outcomes (dependent variables) using nonparametric- or, in case of normally distributed data, parametric- statistical tests.
Retinal reattachment rate in phakic eyes was 94.9% compared to 93.1% in pseudophakic, with no statistically significant difference between the two. The overall retinal reattachment rate with single surgery was 94.0%. Final reattachment rate was 97.4%. In case of established PVR ≥ C1, the reattachment rate was not statistically different (92.6%) from eyes with no PVR (91.1%) irrespective of lens status. A statistically significant difference was found between redetachment rates only between phakic eyes with gas tamponade compared to silicon oil (SO) (p = 0.001). Reattachment rate proved to be similar in both AL groups (≤24 mm and > 24 mm).
High anatomical success rate of primary vitrectomy for complex RRD with either gas or SO tamponade was achieved in phakic as well as pseudophakic eyes irrespective of AL of the eye.
玻璃体切割术（PPV）是治疗复杂性孔源性视网膜脱离（RRD）的首选手术方法。本研究的目的是评估原发性PPV治疗原发性复杂性RRD的解剖学结果，并确定晶状体状态、填充剂、术前增殖性玻璃体视网膜病变（PVR）和眼轴长度（AL）对解剖学结果的影响。
对117例接受PPV治疗的复杂性RRD患者的117只眼进行回顾性连续病例分析。59只为有晶状体眼，58只为无晶状体眼。所有患者的最短随访期为12个月。根据自变量将眼部分为不同组（第一分类基于晶状体状态和所用填充剂，第二分类基于晶状体和PVR状态，第三分类基于眼轴长度）。使用非参数检验或（在数据呈正态分布的情况下）参数统计检验比较各组的解剖学结果（因变量）。
有晶状体眼的视网膜复位率为94.9%，无晶状体眼为93.1%，两者之间无统计学显著差异。单次手术的总体视网膜复位率为94.0%。最终复位率为97.4%。在已确诊PVR≥C1的情况下，无论晶状体状态如何，复位率与无PVR的眼（91.1%）相比无统计学差异（92.6%）。仅在使用气体填充的有晶状体眼与硅油（SO）填充的有晶状体眼之间，再脱离率存在统计学显著差异（p = 0.001）。两个眼轴长度组（≤24mm和>24mm）的复位率相似。
无论眼轴长度如何，有晶状体眼和无晶状体眼在使用气体或SO填充的情况下，原发性玻璃体切割术治疗复杂性RRD均取得了较高的解剖学成功率。
