伴有脉络膜视网膜缺损的孔源性视网膜脱离的手术结果及并发症：KKESH国际视网膜协作研究组的结果

SURGICAL OUTCOMES AND COMPLICATIONS OF RHEGMATOGENOUS RETINAL DETACHMENT IN EYES WITH CHORIORETINAL COLOBOMA: The Results of the KKESH International Collaborative Retina Study Group.

作者信息

Abouammoh Marwan A, Alsulaiman Sulaiman M, Gupta Vishali S, Younis Afnan, Chhablani Jay, Hussein Abdullah, Casella Antonio M, Banker Alay S, Arevalo J Fernando

机构信息

*Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; †Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; ‡Department of Ophthalmology, Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India; §Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; ¶Smt. Kanuri Santhamma Retina Vitreous Centre, L.V. Prasad Eye Institute, Hyderabad, India; **Department of Ophthalmology, Universidade Estadual de Londrina, Londrina, Brazil; ††Banker's Retina Clinic and Laser Centre, Gujarat, India; and ‡‡Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

出版信息

Retina. 2017 Oct;37(10):1942-1947. doi: 10.1097/IAE.0000000000001444.

DOI:10.1097/IAE.0000000000001444

PMID:28067725

Abstract

PURPOSE

To study the outcomes of management of rhegmatogenous retinal detachment in eyes with chorioretinal colobomas.

METHODS

A retrospective review of 119 patients (119 eyes) with chorioretinal colobomas who underwent surgical repair for rhegmatogenous retinal detachment was performed. Data were collected on the site of the retinal break, type of surgery, anatomical success, and complications.

RESULTS

The most common location of the primary retinal break was the intercalary membrane in 58.8% of eyes. The most common surgical intervention was vitrectomy with endolaser and silicone oil tamponade (77.3% of eyes). Final anatomical success was achieved in 87.4% of eyes. Anatomical success was significantly higher in eyes that received long-acting tamponade (P = 0.006). Cryotherapy was significantly associated with failure of primary vitrectomy (P = 0.028). Placement of an encircling band did not affect anatomical outcomes (P = 0.75). Most of the eyes (60%) with recurrent retinal detachment after primary vitrectomy had a primary break within the normal retina.

CONCLUSION

The optimal option for managing retinal detachment in eyes with chorioretinal colobomas is pars plana vitrectomy with long-acting tamponade (silicone oil or octafluoropropane) and retinopexy to the edge of the coloboma and the primary breaks. Cryotherapy is associated with poor anatomical outcomes. An encircling band does not seem to affect the final anatomical outcome.

摘要

目的

研究脉络膜视网膜缺损眼孔源性视网膜脱离的治疗效果。

方法

对119例（119眼）脉络膜视网膜缺损并接受孔源性视网膜脱离手术修复的患者进行回顾性研究。收集视网膜裂孔位置、手术类型、解剖学成功情况及并发症等数据。

结果

原发性视网膜裂孔最常见的位置是中间膜，占58.8%的眼。最常见的手术干预是玻璃体切除术联合眼内激光和硅油填充（77.3%的眼）。87.4%的眼最终获得了解剖学成功。接受长效填充的眼解剖学成功率显著更高（P = 0.006）。冷冻疗法与初次玻璃体切除术失败显著相关（P = 0.028）。环扎带的放置不影响解剖学结果（P = 0.75）。初次玻璃体切除术后视网膜脱离复发的大多数眼（60%）在正常视网膜内有原发性裂孔。