三级医疗中心气性视网膜固定术治疗孔源性视网膜脱离的疗效
Outcomes of Pneumatic Retinopexy for the Management of Rhegmatogenous Retinal Detachment at a Tertiary Care Center.
作者信息
Hazzazi Mohammad A, Al Rashaed Saba
机构信息
Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
出版信息
Middle East Afr J Ophthalmol. 2017 Jul-Sep;24(3):143-147. doi: 10.4103/meajo.MEAJO_137_15.
PURPOSE
The purpose of the study was to report the outcomes of pneumatic retinopexy (PR) for rhegmatogenous retinal detachment (RRD).
METHODS
A retrospective chart review of all patients with RRD who were managed with PR at the King Khaled Eye Specialist Hospital between 2000 and 2014. Data were collected on preoperative ocular history, characteristics of the RRD, postoperative anatomical and visual outcomes, and secondary surgeries.
RESULTS
Sixty-five eyes comprised the study sample with mean a follow-up of 42 months. Eighteen (27%) eyes had a history of ocular surgery and 5 (7.6%) had previous ocular trauma. Thirty-nine (60%) eyes had macula on RRD. Retinal detachment (RD) was caused by a single break in fifty (76.9%) eyes. Superior breaks were found in 56 (86.1%) eyes. Twelve (18%) eyes had posterior vitreous detachment. Fifty-one (78.5%) eyes underwent PR under local anesthesia and 9 (13.8%) underwent conjunctival peritomy. Octafluoropropane gas was used in 49 (75.4%) eyes and sulfur hexafluoride in 16 (24.6%) eyes. Cryotherapy was performed in 48 (73.8%) eyes and only laser photocoagulation in 8 (12.3%) eyes. Nine (13.8%) eyes underwent both cryotherapy and laser photocoagulation. Primary anatomical healing was achieved in 45 (69.2%) eyes, of which 20 (30.8%) required a second intervention. The final anatomical outcome was achieved in 100% of the eyes. At final visit, vision improved in 72% of eyes, was maintained in14.5%, and decreased in 9.7% (6).
CONCLUSION
PR is a safe procedure for RRD repair. The final anatomical outcome was excellent in all cases including the recurrent RD after primary failure.
目的
本研究旨在报告气体视网膜固定术（PR）治疗孔源性视网膜脱离（RRD）的效果。
方法
对2000年至2014年间在沙特国王哈立德眼科专科医院接受PR治疗的所有RRD患者进行回顾性病历分析。收集术前眼部病史、RRD特征、术后解剖和视力结果以及二次手术的数据。
结果
65只眼纳入研究样本，平均随访42个月。18只眼（27%）有眼部手术史，5只眼（7.6%）有眼部外伤史。39只眼（60%）RRD累及黄斑。50只眼（76.9%）视网膜脱离（RD）由单一裂孔引起。56只眼（86.1%）发现上方裂孔。12只眼（18%）有玻璃体后脱离。51只眼（78.5%）在局部麻醉下接受PR，9只眼（13.8%）接受结膜环行切开术。49只眼（75.4%）使用八氟丙烷气体，16只眼（24.6%）使用六氟化硫。48只眼（73.8%）进行了冷冻疗法，8只眼（12.3%）仅进行了激光光凝。9只眼（13.8%）同时进行了冷冻疗法和激光光凝。45只眼（69.2%）实现了一期解剖愈合，其中20只眼（30.8%）需要二次干预。所有眼均实现了最终解剖结果。末次随访时，72%的眼视力提高，14.5%的眼视力维持稳定，9.7%的眼视力下降（6只眼）。
结论
PR是修复RRD的安全手术。包括初次手术失败后的复发性RD在内，所有病例的最终解剖结果均良好。
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