[增殖性玻璃体视网膜病变高危的孔源性视网膜脱离的手术治疗]

[Surgical treatment of rhegmatogenous retinal detachments with high risk of proliferative vitreoretinopathy].

作者信息

Akhundova L A, Kasimov E M

机构信息

National Centre of Ophthalmology named after acad. Zarifa Aliyeva, 32/15 Javadkhan St., Baku, Azerbaijan, AZ 1114.

出版信息

Vestn Oftalmol. 2017;133(3):51-57. doi: 10.17116/oftalma2017133351-57.

DOI:10.17116/oftalma2017133351-57

PMID:28745657

Abstract

AIM

to analyze the effect of internal limiting membrane (ILM) peeling in patients undergoing 23-gauge pars plana vitrectomy for the treatment of rhegmatogenous retinal detachment (RRD) with a high risk of proliferative vitreoretinopathy (PVR).

MATERIAL AND METHODS

This was a prospective consecutive study of 231 eyes of 227 patients. All eyes underwent vitrectomy with silicone oil/gas tamponade for RRD with a high risk of PVR: in 42 eyes the ILM was peeled (group 1) and in the remaining 189 eyes - was not (group 2). The follow-up period was at least 3 months.

RESULTS

In group 1, single-surgery anatomic success was achieved in 85.4% and definitive reattachment - in 95.2% of patients. In group 2, single-surgery anatomic success was achieved in 67.2% and definitive reattachment - in 89.4% of patients. None of the patients from group 1, who had their ILM peeled, developed epiretinal membrane. Final BCVA in groups 1 and 2 was 1.2±0.5 logMAR and 1.34±0.82 logMAR respectively (p=0.297).

CONCLUSION

ILM peeling during vitrectomy in RRD patients at high risk of PVR provides high primary anatomic success rate.

摘要

目的

分析在23G经睫状体平坦部玻璃体切除术治疗具有增殖性玻璃体视网膜病变（PVR）高风险的孔源性视网膜脱离（RRD）患者中，内界膜（ILM）剥除的效果。

材料与方法

这是一项对227例患者的231只眼进行的前瞻性连续研究。所有眼睛均因具有PVR高风险的RRD接受了硅油/气体填充的玻璃体切除术：42只眼进行了ILM剥除（第1组），其余189只眼未进行（第2组）。随访期至少为3个月。

结果

在第1组中，85.4%的患者单次手术获得解剖学成功，95.2%的患者实现最终复位。在第2组中，67.2%的患者单次手术获得解剖学成功，89.4%的患者实现最终复位。第1组中接受ILM剥除的患者均未发生视网膜前膜。第1组和第2组的最终最佳矫正视力（BCVA）分别为1.2±0.5 logMAR和1.34±0.82 logMAR（p = 0.297）。