Frisina Rino
Department of Ophthalmology, University of Padua, Padua, Italy.
Eur J Ophthalmol. 2021 Sep;31(5):NP88-NP92. doi: 10.1177/1120672120927268. Epub 2020 Jun 8.
The author describes a customized posterior scleral reinforcement, its manufacturing method, the rationale of its therapeutic effect, and the surgical technique of its implantation. A 54-year-old female patient with a case history of myopic macular hole with retinal detachment and posterior staphyloma, refractory to pars plana vitrectomy and peeling of internal limiting membrane, underwent posterior scleral reinforcement treatment. Retinal reattachment and macular hole closure were obtained. Best corrected visual acuity increased from light perception to 20/160 Snellen. The pars plana vitrectomy is mandatory to remove vitreoretinal tractions and epiretinal membranes; furthermore, the internal limiting membrane peeling makes retina less rigid. However, it may not be sufficient to allow retinal reattachment and it plays no preventive role in limiting posterior staphyloma progression. The rationale of posterior scleral reinforcement is to reduce retinal stretching, to contain posterior staphyloma, and to limit its progression over time.
作者描述了一种定制的后巩膜加固术、其制造方法、治疗效果的原理以及植入的手术技术。一名54岁女性患者，有近视性黄斑裂孔伴视网膜脱离和后巩膜葡萄肿病史，对玻璃体切割术和平坦部玻璃体切除术及内界膜剥除术无效，接受了后巩膜加固治疗。视网膜实现了复位，黄斑裂孔闭合。最佳矫正视力从光感提高到20/160（斯内伦视力表）。平坦部玻璃体切除术对于消除玻璃体视网膜牵拉和视网膜前膜是必不可少的；此外，内界膜剥除使视网膜的刚性降低。然而，这可能不足以实现视网膜复位，并且在限制后巩膜葡萄肿进展方面没有预防作用。后巩膜加固的原理是减少视网膜拉伸，控制后巩膜葡萄肿，并限制其随时间的进展。
