Istanbul Retina Institute, Istanbul, Turkey.
Retina. 2019 Apr;39(4):736-742. doi: 10.1097/IAE.0000000000002014.
To estimate the outcomes of retinal detachment in eyes with chorioretinal coloboma managed by pars plana vitrectomy and silicone oil tamponade.
A retrospective chart review of 10 eyes (10 patients) who underwent pars plana vitrectomy for retinal detachment with chorioretinal coloboma.
The average age at the time of the surgery was 29.8 ± 19.7 years. The mean follow-up period was 28.8 ± 28.4 months. The mean silicone oil tamponade duration was 9.8 ± 3.5 weeks. Of 10 eyes, 4 (40%) had retinal breaks outside the coloboma, 4 (40%) had breaks inside the coloboma, 1 (10%) had breaks inside and outside the coloboma, and in 1 eye (10%); the causative retinal break was not localized. Preoperatively, the mean visual acuity was 20/2,500 (n = 9), and 1 (10%) was recorded as "Not CSM." At the final examination, the mean visual acuity for the patients with measurable visual acuity was 20/200 (P = 0.06), and in the remaining eye was recorded as light perception. The retina was finally reattached in nine eyes (90%). Postoperative complications included cataract in three (30%), persistent elevated intraocular pressure in one (10%), band keratopathy in one (10%), and proliferative vitreoretinopathy in one (10%).
Complete pars plana vitrectomy with or without lensectomy, laser photocoagulation around the peripheral retina, around all the peripheral breaks and around the colobomatous area, and silicone oil tamponade is effective for retinal detachment in eyes with chorioretinal coloboma. Silicone oil removal as early as possible did not increase the risk of redetachment and seems to reduce the incidence of oil-related complications in such cases.
评估视网膜脱离合并脉络膜视网膜缺损患者行玻璃体切除术联合硅油填充的治疗效果。
回顾性分析 10 例（10 只眼）接受玻璃体切除术联合硅油填充治疗视网膜脱离合并脉络膜视网膜缺损的患者。
手术时患者的平均年龄为 29.8±19.7 岁。平均随访时间为 28.8±28.4 个月。平均硅油填充时间为 9.8±3.5 周。10 只眼中，4 只眼（40%）的视网膜裂孔位于脉络膜视网膜缺损以外，4 只眼（40%）位于缺损以内，1 只眼（10%）位于缺损内外，1 只眼（10%）的视网膜裂孔未定位。术前平均视力为 20/2500（n=9），1 只眼（10%）记录为“非 CSM”。末次随访时，可测量视力患者的平均视力为 20/200（P=0.06），另一只眼记录为光感。9 只眼（90%）的视网膜最终复位。术后并发症包括 3 只眼（30%）白内障、1 只眼（10%）持续性高眼压、1 只眼（10%）角膜带状变性和 1 只眼（10%）增殖性玻璃体视网膜病变。
对于视网膜脱离合并脉络膜视网膜缺损的患者，行完全性玻璃体切除术联合晶状体切除术，对周边视网膜、所有周边裂孔及脉络膜视网膜缺损区行激光光凝，硅油填充治疗效果良好。尽早取出硅油并不会增加再脱离的风险，且似乎可以降低此类病例中与硅油相关的并发症的发生率。
