Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Department of Glaucoma, Medical Research Foundation, Sankara Netralaya, Chennai, Tamil Nadu, India.
Indian J Ophthalmol. 2018 Dec;66(12):1820-1824. doi: 10.4103/ijo.IJO_438_18.
To evaluate the outcome of rhegmatogenous retinal detachment (RRD) surgery in eyes with preplaced glaucoma drainage device (GDD) with respect to intraocular pressure (IOP) control as well as success of retinal detachment (RD) surgery.
It is a retrospective case series. The case records of patients who underwent RD surgery after GDD implantation from 2000 to 2014 were screened. The demographic data, ocular examination findings at all visits, details pertaining to retinal detachment and its repair, and the postoperative course was documented.
Twelve patients were included in study. The mean age of patients was 24.3 years (median 11 years; range 3-72 years). Male: Female ratio was 3:1. Mean duration between GDD and RD was 24 months (4 days-91 months). Of the ten eyes that underwent surgery, nine eyes underwent pars plana vitrectomy, and in one eye scleral buckling was done. GDD was removed only in one eye. At final follow-up, retina was attached with controlled IOP in 6 (60%) eyes, of which 5 (50%) had improvement in best corrected visual acuity.
Pars plana vitrectomy was required in almost all cases for the management of RD in eyes with preplaced GDD. Retinal reattachment with good IOP control could be achieved in 60% of eyes. Removal of the drainage device was not essential for the effective management of the RRD in most cases. With multidisciplinary approach, close follow-up and timely intervention, vision can be preserved along with glaucoma control and successful retinal reattachment.
评估预先放置的青光眼引流装置(GDD)后行孔源性视网膜脱离(RRD)手术的结果,包括眼压(IOP)控制和视网膜脱离(RD)手术的成功率。
这是一项回顾性病例系列研究。筛选了 2000 年至 2014 年间接受 GDD 植入后行 RD 手术的患者的病例记录。记录了患者的人口统计学数据、所有就诊时的眼部检查结果、与视网膜脱离及其修复相关的详细信息,以及术后过程。
研究纳入了 12 名患者。患者的平均年龄为 24.3 岁(中位数为 11 岁;范围 3-72 岁)。男女比例为 3:1。GDD 与 RD 之间的平均时间为 24 个月(4 天-91 个月)。在接受手术的 10 只眼中,9 只眼行玻璃体切割术,1 只眼行巩膜扣带术。仅在 1 只眼中移除了 GDD。在最终随访时,6 只眼(60%)视网膜贴附,眼压得到控制,其中 5 只眼(50%)最佳矫正视力有所改善。
对于预先放置 GDD 的眼中 RD 的管理,几乎所有情况下都需要行玻璃体切割术。60%的眼中可以实现视网膜再贴附,同时眼压得到良好控制。在大多数情况下,移除引流装置对于 RRD 的有效管理并非必需。通过多学科方法、密切随访和及时干预,可以在控制青光眼和成功视网膜再贴附的同时保留视力。