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25G玻璃体切除术联合气体治疗孔源性视网膜脱离

25-gauge vitrectomy and gas for the management of rhegmatogenous retinal detachment.

作者信息

Veith Miroslav, Stranak Zbynek, Pencak Martin, Vranova Jana, Studeny Pavel

机构信息

Department of Ophthalmology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University in Prague, Czech Republic.

Department of Medical Biophysics and Medical Informatics, Third Faculty of Medicine, Charles University in Prague, Czech Republic.

出版信息

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019 Feb;163(1):80-84. doi: 10.5507/bp.2018.034. Epub 2018 Jun 21.

Abstract

AIMS

To evaluate the anatomical and functional results in patients with rhegmatogenous retinal detachment (RRD) who underwent 25-gauge pars plana vitrectomy (PPV) with gas tamponade.

MATERIALS AND METHODS

A retrospective evaluation of 126 eyes of 126 patients (79 men, 47 women) with RRD who underwent 25-gauge PPV with gas tamponade (13% C3F8 in 87 eyes, 20% SF6 in 39 eyes). 113 patients (89.7%), were operated on under local anaesthesia, 13 patients (10.3%) under general anaesthesia. Macula was detached in 85 eyes (67.5%). 53 eyes had pseudophakic RRD, 73 eyes were phakic. Anatomical success of the primary intervention, change in best corrected visual acuity (BCVA) and incidence of complications were assessed. An average follow-up period is 7.2 months (6-15).

RESULTS

With single operation, retinal attachment was achieved in 125 eyes (99.2%); the final anatomical success was 100%. The initial mean BCVA was 0.89 logMar (2.00 to 0.00); at the end of the follow-up period, it improved to 0.23logMAR (1.00 to -0.10), P < 0,0001. During the first post-intervention day, hypotony of the eye below 10 mmHg was observed in 1 patient (0.8%); on the contrary, intraocular pressure was temporarily increased to 25 mmHg and more in 36 patients (28.6%).

CONCLUSION

The surgical treatment of RRD using 25-gauge PPV with expansive gas tamponade renders excellent anatomical results and improvement in BCVA. The incidence of complications and necessity of sclerotomy suturing are low.

摘要

目的

评估接受25G玻璃体切割联合气体填充术治疗的孔源性视网膜脱离(RRD)患者的解剖和功能结果。

材料与方法

回顾性分析126例(79例男性,47例女性)RRD患者的126只眼,这些患者均接受了25G玻璃体切割联合气体填充术(87只眼填充13%的C3F8,39只眼填充20%的SF6)。113例患者(89.7%)在局部麻醉下手术,13例患者(10.3%)在全身麻醉下手术。85只眼(67.5%)黄斑脱离。53只眼为人工晶状体眼RRD,73只眼为晶状体眼。评估初次干预的解剖学成功率、最佳矫正视力(BCVA)的变化及并发症发生率。平均随访时间为7.2个月(6 - 15个月)。

结果

单次手术后,125只眼(99.2%)实现视网膜复位;最终解剖学成功率为100%。初始平均BCVA为0.89 logMar(2.00至0.00);随访期末,提高至0.23 logMAR(1.00至 - 0.10),P < 0.0001。术后第1天,1例患者(0.8%)出现眼压低于10 mmHg的低眼压;相反,36例患者(28.6%)眼压暂时升高至25 mmHg及以上。

结论

采用25G玻璃体切割联合膨胀性气体填充术治疗RRD可获得优异的解剖学结果,并改善BCVA。并发症发生率及巩膜切开缝合的必要性较低。

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