Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China; and.
Singapore National Eye Centre, Singapore Eye Research Institute, Singapore.
Retina. 2020 Nov;40(11):2077-2082. doi: 10.1097/IAE.0000000000002744.
To report surgical outcomes of 25-gauge pars plana vitrectomy using air as an internal tamponade for patients with primary rhegmatogenous retinal detachment (RRD).
A retrospective clinical study of 59 eyes of 59 consecutive patients presented with primary RRD at the Beijing Tongren Eye Center in China. From August 2016 to May 2018, medical records of the patients who underwent 25-gauge pars plana vitrectomy with air tamponade for RRD were reviewed. The main outcome measures were primary and final anatomical success (retinal re-attachment) rates, and postoperative complications.
Of the 59 patients, aged 54.47 ± 11.81 years, 31 (52.5%) were men. Vitrectomy was performed 3 to 40 (averaged 16.98 ± 10.17) days after the onset of symptoms, and the mean follow-up period was 12.90 ± 5.92 months (ranging 6.07-26.10 months). Forty-two eyes (71.2%) had RRD with retinal breaks in the superior half of the retina, and the mean number of retinal breaks was 1.75 ± 0.94. Three eyes (5.1%) had RRD with giant retinal tears. Of the 59 eyes, 35 (59.3%) had RRD with inferior quadrants involved. Proliferative vitreoretinopathy (PVR) gradings were C1 in 2 (3.4%) eyes and B or below in 57 (96.6%) eyes. The primary and final anatomical success rates were 94.9% (56/59) and 98.3% (58/59), respectively. Of the three eyes which developed re-detachment of the retina, one eye had postoperative progression of PVR and two eyes were RRD associated with macular hole in high myopia. Postoperative complications included 5 eyes (8.5%) with serous choroidal detachment within 3 days after surgery and 4 eyes (6.8%) with macular epiretinal membrane formation 1 to 8 months after surgery. Secondary cataract surgery was performed in 13 of the 53 phakic eyes (24.5%) during follow-up.
Small-gauge pars plana vitrectomy with air tamponade may be effective in treating selected cases of relatively simple primary RRD. Additional studies are needed to verify the efficacy of this surgical approach for more complicated cases such as those with giant retinal tears.
报告 25G 经睫状体平坦部玻璃体切割术联合空气内填充治疗原发性孔源性视网膜脱离（RRD）的手术效果。
回顾性临床研究。收集 2016 年 8 月至 2018 年 5 月于首都医科大学附属北京同仁医院就诊的 59 例（59 只眼）原发性 RRD 患者的临床资料。患者均行 25G 经睫状体平坦部玻璃体切割术联合空气内填充治疗，观察患者的主要手术效果及术后并发症。
59 例患者中，男 31 例（52.5%），女 28 例（47.5%）；年龄 54.47±11.81 岁。发病至手术时间为 3～40 d，平均（16.98±10.17）d。随访 6.07～26.10 个月，平均 12.90±5.92 个月。视网膜脱离累及象限：下方 35 只眼（59.3%），上方 42 只眼（71.2%）。裂孔位于上方视网膜者占 71.2%，平均 1.75±0.94 个。合并巨大裂孔 3 只眼（5.1%）。术前增殖性玻璃体视网膜病变（PVR）分级：C1 2 只眼（3.4%），B 级及以下 57 只眼（96.6%）。术后视网膜解剖复位率为 98.3%（58/59）。术后 3 d 内发生脉络膜脱离 5 只眼（8.5%），术后 1～8 个月发生黄斑区视网膜前膜 4 只眼（6.8%）。随访期间行二期白内障超声乳化抽吸术 13 只眼（24.5%）。
25G 经睫状体平坦部玻璃体切割术联合空气内填充治疗相对简单的原发性 RRD 是有效的，对于更复杂的病例，如合并巨大裂孔的 RRD，需要进一步研究证实其疗效。
