Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan.
Oshima Eye Clinic, Takatsuki, Japan.
Graefes Arch Clin Exp Ophthalmol. 2019 Dec;257(12):2591-2600. doi: 10.1007/s00417-019-04448-2. Epub 2019 Sep 2.
To evaluate the surgical outcomes of the 27-gauge (G) vitrectomy system for the treatment of primary rhegmatogenous retinal detachment (RRD).
This retrospective consecutive series multicenter study involved a total of 410 eyes of 406 patients who underwent 3-port transconjunctival 27G pars plana vitrectomy (PPV) for RRD between November 2014 and December 2016 and who were followed for a minimum of 3 months postoperative. The main outcome measure was primary reattachment, with the secondary outcome measures being final reattachment, improvement of visual acuity (VA), intraocular pressure (IOP), intraoperative and postoperative complications, and surgery time.
Of the 410 treated eyes, primary reattachment was achieved in 392 (95.6%) and final reattachment was achieved in 410 (100%). In 226 eyes (55.1%) with macula-on RRD, the mean logarithm of the minimum angle of resolution (logMAR) VA improved from 0.16 ± 0.51 pre-surgery to 0.02 ± 0.14 post-surgery (P = 0.11). In 184 eyes (44.9%) with macula-off RRD, logMAR VA improved from 1.06 ± 0.77 pre-surgery to 0.26 ± 0.35 post-surgery (P < 0.001). Following surgery, the mean IOP was highest at 1 day (15.7 ± 7.0 mmHg) postoperative. In all eyes, surgery was concluded without the use of sutures or the need of conversion to a larger-gauge instrument. Although hypotony was observed in 14 (3.4%) of the 410 treated eyes at 1 day postoperative, it spontaneously resolved within 1 week without additional surgical intervention. No postoperative complications such as infectious endophthalmitis were observed throughout the follow-up period.
Our findings show that 27G PPV is both safe and effective for the treatment of primary RRD.
评估 27G（G）套管玻璃体切除术系统治疗原发性孔源性视网膜脱离（RRD）的手术效果。
这是一项回顾性连续多中心研究，共纳入 2014 年 11 月至 2016 年 12 月期间接受 3 端口经结膜 27G 睫状体平坦部玻璃体切除术（PPV）治疗的 406 例 410 只眼 RRD 患者，所有患者均至少随访 3 个月。主要观察指标为初次复位，次要观察指标为最终复位、视力（VA）改善、眼内压（IOP）、术中及术后并发症及手术时间。
410 只眼中，392 只（95.6%）眼初次复位，410 只（100%）眼最终复位。226 只（55.1%）黄斑区视网膜前 RRD 眼，平均最小分辨角对数（logMAR）VA 从术前 0.16±0.51 提高到术后 0.02±0.14（P=0.11）。184 只（44.9%）黄斑区视网膜下 RRD 眼，logMAR VA 从术前 1.06±0.77 提高到术后 0.26±0.35（P<0.001）。术后 1 天（15.7±7.0mmHg）平均眼压最高。所有患者手术均无需缝线或改用较大规格器械。尽管术后 1 天有 14 只（3.4%）眼出现低眼压，但无需进一步手术干预，1 周内自发缓解。整个随访期内未观察到感染性眼内炎等术后并发症。
我们的研究结果表明，27G PPV 治疗原发性 RRD 安全有效。
