Lindsell Luke B, Sisk Robert A, Miller Daniel M, Foster Robert E, Petersen Michael R, Riemann Christopher D, Hutchins Robert K
Cincinnati Eye Institute, Department of Ophthalmology, University of Cincinnati, Cincinnati, OH, USA.
Clin Ophthalmol. 2016 Dec 20;11:47-54. doi: 10.2147/OPTH.S112190. eCollection 2017.
To assess the combination of scleral buckling (SB) and pars plana vitrectomy (PPV) versus PPV alone in the primary repair of rhegmatogenous retinal detachments (RRDs).
The current study was a retrospective, comparative, interventional, consecutive case series of 179 eyes of 174 patients who underwent primary RRD repair by five surgeons between January 1, 2008 and December 31, 2010, utilizing SB with PPV or PPV. Univariate and multivariate analyses were used to compare the efficacy of the two surgical strategies and assess for risk factors of proliferative vitreoretinopathy (PVR).
Single surgery anatomic success (SSAS) was similar (=0.76) between the PPV group (112 of 132 eyes, 85%) and SB with PPV group (39 of 47 eyes, 83%). Final anatomic success was 100% in each group. There was no difference in rates of PVR formation (PPV 16% vs SB with PPV 19%, =0.70). Final logarithm of the minimum angle of resolution acuity was 0.33 (20/43) in the PPV group and 0.37 (20/47) in the SB with PPV group (=0.62). Postoperative anterior chamber fibrin was highly correlated with PVR formation (PVR 13% vs no PVR 0.7%, =0.003; odds ratio =68.37, =0.007). Separate analysis of medium- to high-complexity cases showed similar SSAS (PPV 86% vs SB with PPV 83%, =0.45).
SB with PPV versus PPV alone were similarly efficacious for repair of primary RRDs of varying complexity. SSAS rates, PVR incidence, and final visual acuities were not significantly different.
评估巩膜扣带术（SB）联合玻璃体切割术（PPV）与单纯PPV在原发性孔源性视网膜脱离（RRD）修复中的效果。
本研究为回顾性、对比性、干预性、连续性病例系列，纳入了2008年1月1日至2010年12月31日期间由5位外科医生进行原发性RRD修复的174例患者的179只眼，采用SB联合PPV或单纯PPV。采用单因素和多因素分析比较两种手术策略的疗效，并评估增殖性玻璃体视网膜病变（PVR）的危险因素。
PPV组（132只眼中的112只，85%）和SB联合PPV组（47只眼中的39只，83%）的单次手术解剖成功率（SSAS）相似（=0.76）。每组的最终解剖成功率均为100%。PVR形成率无差异（PPV组为16%，SB联合PPV组为19%，=0.70）。PPV组的最终最小分辨角对数视力为0.33（20/43），SB联合PPV组为0.37（20/47）（=0.62）。术后前房纤维蛋白与PVR形成高度相关（PVR组为13%，无PVR组为0.7%，=0.003；优势比=68.37，=0.007）。对中高复杂性病例的单独分析显示SSAS相似（PPV组为86%，SB联合PPV组为83%，=0.45）。
SB联合PPV与单纯PPV在修复不同复杂性的原发性RRD方面疗效相似。SSAS率、PVR发生率和最终视力无显著差异。
