Department of Vitreo-retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India.
Int Ophthalmol. 2021 Jan;41(1):135-141. doi: 10.1007/s10792-020-01560-9. Epub 2020 Aug 28.
To evaluate the outcome and safety profile of short-term perfluorocarbon liquids (PFCL) tamponade in comparison with buckle-vitrectomy in case of rhegmatogenous retinal detachment (RRD) associated with choroidal detachment (CD).
Records of patients who underwent surgery for RRD/CD from January 2016 to July 2019 were reviewed retrospectively. The patients were allocated into two groups-group 1 patients underwent buckle-vitrectomy, while those in group 2 underwent a two-staged vitrectomy with short-term (5 days) PFCL tamponade.
The study included 33 eyes (33 patients) with mean age of 50.3 ± 17.2 years. Group 1 included 15 patients, while group 2 included 18. The pre-operative characteristics were similar in both the groups. The mean pre-operative intraocular pressure in group 1 and 2 was 9.1 ± 4.0 and 8.6 ± 5.2 mmHg, respectively (p = 0.755). Retinal re-attachment after single surgery was achieved in 10 (66.7%) and 14 eyes (77.8%), respectively. All the eyes achieved retinal re-attachment after repeat surgery in both the groups (1.40 vs 1.39 surgeries, p = 0.963). Post-surgery visual improvement was seen in 13 (86.7%) and 17 eyes (94.4%), respectively (p = 0.579). Final visual acuity of ≥ 6/60 was obtained in 7 (46.7%) and 9 eyes (50.0%), respectively (p > 0.999). None of the patients needed retinectomy during repeat surgery. None of the patients experienced exaggerated inflammation or intractable raised IOP spike which could not be controlled with medications.
Surgical outcomes were similar in both the groups. No clinically apparent toxicity was seen with post-operative short-term PFCL tamponade. Two-staged surgery is a good alternative to buckle-vitrectomy for eyes with RRD associated with CD.
评估短期全氟碳液体(PFCL)与巩膜扣带术在治疗伴有脉络膜脱离的孔源性视网膜脱离(RRD)中的疗效和安全性。
回顾性分析 2016 年 1 月至 2019 年 7 月接受手术治疗的 RRD/CD 患者的病历资料。将患者分为两组:1 组患者接受巩膜扣带术,2 组患者接受 2 期玻璃体切割术,术中短期(5 天)使用 PFCL 进行眼内填充。
本研究共纳入 33 只眼(33 例患者),平均年龄为 50.3±17.2 岁。1 组患者 15 例,2 组患者 18 例。两组患者的术前特征相似。1 组和 2 组患者的术前平均眼压分别为 9.1±4.0mmHg 和 8.6±5.2mmHg(p=0.755)。单次手术后,10 只眼(66.7%)和 14 只眼(77.8%)视网膜复位。两组患者均在重复手术后实现视网膜完全复位(1.40 次 vs 1.39 次手术,p=0.963)。术后视力提高的患者分别为 13 例(86.7%)和 17 例(94.4%)(p=0.579)。最终视力≥6/60 的患者分别为 7 例(46.7%)和 9 例(50.0%)(p>0.999)。在重复手术中,没有患者需要进行视网膜切除术。没有患者出现明显的炎症或药物无法控制的难以控制的眼压升高。
两组患者的手术效果相似。术后短期使用 PFCL 填充未出现明显的毒性反应。对于伴有脉络膜脱离的 RRD 患者,2 期手术是巩膜扣带术的一种较好替代方法。