Sahanne Sari, Tuuminen Raimo, Haukka Jari, Loukovaara Sirpa
Department of Anesthesiology, Helsinki University Central Hospital, Helsinki.
Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka.
Clin Ophthalmol. 2017 Mar 10;11:503-509. doi: 10.2147/OPTH.S128746. eCollection 2017.
Rhegmatogenous retinal detachment (RRD) is the most common form of retinal detachment and an ophthalmic emergency. Here, we compared outcomes of primary RRD eyes operated with conventional scleral buckling (SB) with cryoretinopexy to those operated with standard pars plana vitrectomy (PPV).
This is an institutional, retrospective, register-based, observational, comparative study. Based on the surgical procedure, 319 eyes of 319 patients were divided into two groups: SB plus cryotherapy (n=50) and PPV (n=269). Changes in intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were recorded at 30 days and reoperation rates within 180 days postoperatively.
Eyes operated with PPV had less reoperations within the first 180 days as compared with SB eyes (=0.001, log-rank test); however, changes in IOP were more prominent (mean ± standard deviation: +8.1±8.8 vs. +4.4±7.0 mmHg, respectively; =0.006). Changes in BCVA did not differ between the surgical procedures.
PPV was associated with higher primary anatomic success rates and lower risk of reoperation but significant IOP elevation when compared to SB. These factors should be case-specifically considered when choosing treatment modality for primary RRD.
孔源性视网膜脱离（RRD）是视网膜脱离最常见的形式，也是一种眼科急症。在此，我们比较了采用传统巩膜扣带术（SB）联合冷冻视网膜固定术治疗的原发性RRD眼与采用标准玻璃体切除术（PPV）治疗的原发性RRD眼的治疗效果。
这是一项基于机构登记的回顾性观察比较研究。根据手术方式，将319例患者的319只眼分为两组：SB联合冷冻疗法组（n = 50）和PPV组（n = 269）。记录术后30天时的眼压（IOP）变化和最佳矫正视力（BCVA），以及术后180天内的再次手术率。
与SB组相比，PPV组在术后180天内的再次手术率更低（P = 0.001，对数秩检验）；然而，眼压变化更为显著（分别为平均±标准差：+8.1±8.8 mmHg与+4.4±7.0 mmHg；P = 0.006）。两种手术方式在BCVA变化方面无差异。
与SB相比，PPV的原发性解剖成功率更高，再次手术风险更低，但眼压显著升高。在为原发性RRD选择治疗方式时，应根据具体情况考虑这些因素。
