Vidne-Hay Orit, Abumanhal Muhammad, Elkader Amir Abd, Fogel Miri, Moisseiev Joseph, Moisseiev Elad
Department of Ophthalmology, Sheba Medical Center, Ramat Gan, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; and.
Retina. 2020 May;40(5):805-810. doi: 10.1097/IAE.0000000000002483.
To evaluate the visual and anatomical outcomes of reoperations following failure of pneumatic retinopexy (PR) for rhegmatogenous retinal detachment repair and compare the different surgical techniques used in these cases.
The study included 114 eyes of 114 patients who underwent PR for rhegmatogenous retinal detachment and required subsequent surgery for its repair. These included repeated PR, scleral buckling, vitrectomy with gas or silicone oil, and vitrectomy with scleral buckling. The groups were compared for rates of retinal reattachment, visual improvement, and the occurrence of recurrent rhegmatogenous retinal detachment and any other postoperative complications.
In 91 (79.8%) eyes, the retina was reattached with one additional procedure. The success rate was significantly lower in eyes treated by repeated PR than by other surgical techniques (33 vs. 76-90%; P < 0.001). Visual acuity after PR failure was not significantly different than that at presentation and had improved significantly after surgery for retinal reattachment (P < 0.001).
Pneumatic retinopexy failure was not associated with visual acuity loss, and the outcomes in 79.2% of cases that required only one additional surgery are comparable with those achieved with primary surgery. Poor outcomes were associated with eyes that required more than one additional surgery and that suffered complications.
评估气性视网膜固定术（PR）治疗孔源性视网膜脱离失败后再次手术的视觉和解剖学结果，并比较这些病例中使用的不同手术技术。
该研究纳入了114例接受PR治疗孔源性视网膜脱离且随后需要再次手术修复的患者的114只眼。这些手术包括重复PR、巩膜扣带术、玻璃体注气或硅油填充玻璃体切除术以及玻璃体切除联合巩膜扣带术。比较各组的视网膜复位率、视力改善情况、复发性孔源性视网膜脱离的发生率以及任何其他术后并发症。
91只眼（79.8%）通过一次额外手术实现了视网膜复位。重复PR治疗的眼的成功率显著低于其他手术技术治疗的眼（33%对76 - 90%；P < 0.001）。PR失败后的视力与初诊时相比无显著差异，而在视网膜复位手术后视力有显著改善（P < 0.001）。
气性视网膜固定术失败与视力丧失无关，79.2%仅需一次额外手术的病例的结果与初次手术的结果相当。预后不良与需要多次额外手术且出现并发症的眼有关。
