Schmidt I, Plange N, Rößler G, Schellhase H, Koutsonas A, Walter P, Mazinani B
Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
Department of Ophthalmology, St. Martinus-Hospital, Düsseldorf, Germany.
ScientificWorldJournal. 2019 Mar 6;2019:5416806. doi: 10.1155/2019/5416806. eCollection 2019.
Most studies about retinal detachment cover a limited follow-up period. The purpose of this research is to assess the long-term results after pars plana vitrectomy (PPV) and scleral buckle (SB) surgery in patients with rhegmatogenous retinal detachment (RRD).
155 patients with RRD are treated either with SB or PPV with a mean follow-up of more than 5 years. Retrospective analysis of patient data with RRD was performed between January 2006 and June 2008 at a tertiary eye clinic.
Overall primary success rate was 85.2% (PPV: 84.6%, SB: 89.5%; p=0.57). 90.5% of redetachments appeared within the first 124 days. No significant different success rate was found for vitrectomy with and without additional encircling band (p=0.09). No advantage of a supplemental encircling band in cases of preoperative inferior breaks was seen (p=0.81). Patients of SB group were treated more frequently in follow-up time because of epiretinal membrane (ERM) (SB: 15.5% versus PPV: 7.3%). No patient of the PPV group without intraoperative use of endolaser cerclage (14.7%) had any peeling surgery postoperatively.
Redetachment rates of both methods are comparable in a clinical setting where PPV is considered a suitable method for pseudophakic patients and in complex cases and SB was performed in younger phakic patients with clearly identified retinal tears. PPV seems to show a more heterogenous pattern of complications. No advantage of a supplemental encircling band could be found in these case series of patients with primary RRD. No relevant long-term risk of redetachment was seen after SB.
大多数关于视网膜脱离的研究随访期有限。本研究的目的是评估孔源性视网膜脱离（RRD）患者行玻璃体切除术（PPV）和巩膜扣带术（SB）后的长期效果。
155例RRD患者接受了SB或PPV治疗，平均随访时间超过5年。2006年1月至2008年6月在一家三级眼科诊所对RRD患者数据进行了回顾性分析。
总体初次成功率为85.2%（PPV：84.6%，SB：89.5%；p = 0.57）。90.5%的视网膜再脱离发生在最初124天内。有无额外环扎带的玻璃体切除术成功率无显著差异（p = 0.09）。术前下方裂孔病例中未发现补充环扎带的优势（p = 0.81）。SB组患者因视网膜前膜（ERM）在随访期接受治疗的频率更高（SB：15.5% 对PPV：7.3%）。PPV组术中未使用眼内激光环扎术的患者（14.7%）术后均未进行任何剥膜手术。
在临床环境中，PPV被认为适用于人工晶状体眼患者和复杂病例，而SB用于年轻晶状体眼且视网膜裂孔明确的患者，两种方法的视网膜再脱离率相当。PPV似乎并发症模式更具异质性。在这些原发性RRD患者的病例系列中未发现补充环扎带的优势。SB术后未发现相关的视网膜再脱离长期风险。
