Xu Huiyan, Lutrin David, Wu Zhifeng
Department of Ophthalmology, Nanjing Medical University Affiliated Wuxi Second Hospital, Wuxi, Jiangsu Province, China University of California, San Francisco, CA.
Medicine (Baltimore). 2017 Aug;96(34):e7869. doi: 10.1097/MD.0000000000007869.
Rhegmatogenous retinal detachment associated with choroidal detachment (RRDCD) is a special type of complex retinal detachment, and usually has a poor prognosis. This study aimed to assess the anatomical outcomes of 23-gauge pars plana vitrectomy (23G PPV) combined with phacoemulsification (phaco) and capsulotomy without intraocular lens (IOL) implantation in patients with RRDCD.Seventy-six consecutive patients with RRDCD, who underwent retinal repair surgery from January 2010 to December 2014, were retrospectively analyzed. Forty patients underwent 23G PPV + phaco + IOL implantation, and 36 underwent 23G PPV + phaco + capsulotomy without IOL implantation (i.e., aphakia). All cases were filled with silicone oil. The follow-up time was 6 months after silicone oil was removed. Multivariate logistic regression analysis was the statistical method used.The overall retinal anatomical reattachment rate was 58% (44/76): 40% (16/40) of patients receiving 23G PPV + phaco + IOL implantation; and 78% (28/36) of patients receiving 23G PPV + phaco + capsulotomy + aphakia (P = .007).Surgical repair using 23G PPV + phaco + capsulotomy without IOL implantation can improve anatomical reattachment rates in patients with RRDCD.
孔源性视网膜脱离合并脉络膜脱离（RRDCD）是一种特殊类型的复杂性视网膜脱离，通常预后较差。本研究旨在评估23G经睫状体平坦部玻璃体切除术（23G PPV）联合超声乳化白内障吸除术（phaco）及晶状体囊切开术且未植入人工晶状体（IOL）治疗RRDCD患者的解剖学预后。对2010年1月至2014年12月期间连续76例行视网膜修复手术的RRDCD患者进行回顾性分析。40例患者接受了23G PPV + phaco + IOL植入术，36例接受了23G PPV + phaco +晶状体囊切开术且未植入IOL（即无晶状体眼）。所有病例均填充硅油。随访时间为硅油取出后6个月。采用多因素logistic回归分析作为统计方法。视网膜整体解剖复位率为58%（44/76）：接受23G PPV + phaco + IOL植入术的患者为40%（16/40）；接受23G PPV + phaco +晶状体囊切开术+无晶状体眼的患者为78%（28/36）（P = 0.007）。采用23G PPV + phaco +晶状体囊切开术且未植入IOL进行手术修复可提高RRDCD患者的解剖复位率。
