Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Retina. 2018 Apr;38(4):670-677. doi: 10.1097/IAE.0000000000001592.
To study the structural and functional outcomes of 25-gauge pars plana vitrectomy in giant retinal tear-associated retinal detachments.
Seventeen eyes of 17 patients with giant retinal tear, who underwent 25-gauge pars plana vitrectomy over a period of 15 months at a tertiary eye care center by a single surgeon, were recruited in this retrospective interventional study.
Giant retinal tears were mostly traumatic (35.3%) or associated with myopia (35.3%) and occurred in young (mean age 25.7 years) males (94.1%). Most eyes had best-corrected visual acuity ≤20/1,200 (in 82.3%), foveal detachment (in 88.2%), and proliferative vitreoretinopathy ≤Grade B (in 82.3%). The giant retinal tear extent was more than 180° in 29.4% and the fellow eye was involved in 35.2% of eyes. All eyes underwent 25-gauge pars plana vitrectomy with encircling band in 41.1%, perfluorocarbon liquid use in 82.3%, and endotamponade with sulphur hexafluoride (23.6%) or silicone oil (76.4%). At mean follow-up of 10.2 months, reattachment rate was 88.2%. Only 35.2% of eyes achieved final visual acuity ≥20/80 with a cause of poor vision being cataract, secondary glaucoma, macular pucker, and corneal edema.
Twenty-five-gauge pars plana vitrectomy can achieve excellent attachment rates in eyes with giant retinal tear-associated retinal detachment. It can be as efficient as larger-gauge vitrectomy, at the same time retaining all advantages of smaller-gauge surgery.
研究 25G 经睫状体平坦部玻璃体切割术治疗巨大孔源性视网膜脱离的结构和功能结果。
本回顾性干预研究纳入了 17 名（17 只眼）在一家三级眼科中心接受单名外科医生进行的 25G 经睫状体平坦部玻璃体切割术的巨大孔源性视网膜脱离患者。这些患者的巨大孔源性视网膜裂孔在 15 个月的时间内发生。
巨大孔源性视网膜裂孔主要由外伤引起（35.3%）或与近视有关（35.3%），发生于年轻（平均年龄 25.7 岁）男性（94.1%）。大多数患者最佳矫正视力≤20/1200（82.3%），黄斑脱离（88.2%），增生性玻璃体视网膜病变≤B 级（82.3%）。29.4%的患者的巨大孔源性视网膜裂孔超过 180°，35.2%的患者对侧眼受累。所有患者均接受 25G 经睫状体平坦部玻璃体切割术联合环扎带（41.1%）、全氟化碳液体（82.3%），以及硫六氟丙烷（23.6%）或硅油（76.4%）内填充。在平均 10.2 个月的随访中，视网膜复位率为 88.2%。仅有 35.2%的患者最终视力≥20/80，视力不佳的原因是白内障、继发性青光眼、黄斑皱缩和角膜水肿。
25G 经睫状体平坦部玻璃体切割术可使巨大孔源性视网膜脱离眼获得良好的视网膜复位率。它与较大口径玻璃体切割术同样有效，同时保留了小口径手术的所有优势。
