Bilgin Ahmet Burak, Dogan Mehmet Erkan, Aysun Basak, Apaydın Kadri Cemil
Department of Opthalmology, Akdeniz University, Konyaaltı, Antalya, Turkey.
Department of Opthalmology, Elmali State Hospital, 07700, Yeni Mahalle, Elmali, Antalya, Turkey.
Int Ophthalmol. 2019 Aug;39(8):1687-1694. doi: 10.1007/s10792-018-0986-z. Epub 2018 Jul 10.
The aim of this study was to investigate whether intraoperative 360° prophylactic endolaser photocoagulation is necessary for the treatment of uncomplicated retinal detachment.
This prospective, randomized, comparative and interventional study includes 50 consecutive patients with primary rhegmatogenous retinal detachment (RRD) who were treated by pars plana vitrectomy. The patients were divided into two groups: in Group A endolaser applied to all existing breaks as well as a 360° laser retinopexy, while Group B received endolaser only to the retinal breaks. Primary anatomical success rate, a final best-corrected visual acuity (BCVA) and postoperative complications were analyzed and compared between the groups at 1 and 3 months.
After the primary procedure, the retina was reattached in 96% (24 of 25) of patients in Group A and in 88% (22 of 25) of patients in Group B at 1 and 3 months. The mean final BCVA (logarithm of the minimum angle of resolution) improved from 1.26 to 0.52 in Group A with 17 cases (68%) macula-off and 1.19 to 0.77 in Group B with 18 cases (72%) macula-off at preoperative and final follow-up visit. Epiretinal membranes were seen in four cases in Group A and four cases in Group B at 3 months. No statistically significant difference in the anatomical, functional and complication outcomes between the two groups was recorded.
Pars plana vitrectomy without the 360° peripheral endolaser can provide successful anatomic outcomes and functional improvement in uncomplicated primary RRDs.
本研究旨在探讨术中360°预防性视网膜激光光凝术对于单纯性视网膜脱离治疗是否必要。
本前瞻性、随机、对比和干预性研究纳入了50例连续接受玻璃体切割术治疗的原发性孔源性视网膜脱离(RRD)患者。患者被分为两组:A组对所有已发现的裂孔以及进行360°视网膜光凝,而B组仅对视网膜裂孔进行视网膜激光光凝。在1个月和3个月时分析并比较两组的原发性解剖成功率、最终最佳矫正视力(BCVA)和术后并发症。
初次手术后,1个月和3个月时,A组96%(25例中的24例)患者视网膜复位,B组88%(25例中的22例)患者视网膜复位。术前及末次随访时,A组平均最终BCVA(最小分辨角对数)从1.26提高到0.52,黄斑脱离17例(68%);B组平均最终BCVA从1.19提高到0.77,黄斑脱离18例(72%)。3个月时,A组4例和B组4例出现视网膜前膜。两组在解剖、功能和并发症结果方面未记录到统计学显著差异。
不进行360°周边视网膜激光光凝的玻璃体切割术能够为单纯性原发性RRD提供成功的解剖学结果和功能改善。