Girsang Waldensius, Sari Dwi C R, Srigutomo Wahyu, Gondhowiardjo Tjahjono D, Sasongko Muhammad B
Jakarta Eye Center Eye Hospitals and Clinics, Jakarta, Indonesia.
Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada - Sardjito Eye Center, Dr. Sardjito General Hospital, Jalan Farmako Sekip Utara, Yogyakarta, Indonesia.
Int J Retina Vitreous. 2020 Oct 1;6:46. doi: 10.1186/s40942-020-00251-y. eCollection 2020.
To revisit the concept of retinectomy and the theory of mechanical forces on the retina occurring in rhegmatogenous retinal detachment (RRD) and to describe the potential application of radial retinectomy in RRD with advanced proliferative vitreoretinopathy (PVR).
A literature search was performed to identify all English language articles reporting the use of retinectomy for the management of RRD with PVR. We reviewed the theoretical background of mechanical forces occurring in RRD.
Detachment of the retina from the retinal pigment epithelium (RPE)/choroid is influenced by disequilibrium of several physical forces: tangential forces on the epiretinal membrane and radial traction on the retina exceeding the retinal adhesion force to the RPE . PVR may exaggerate the amounts of tangential and radial forces ( and ) that pull the retina off. Relaxing radial retinectomy, by the nature of its cutting pattern, may theoretically decrease the amounts of both forces, therefore restoring the equilibrium between tensile and adhesive forces on the retinal surface .
Relaxing radial retinectomy may potentially be applied in RRD with advanced PVR but has rarely been reported to date. Future studies are needed to evaluate its outcomes and long-term complications.
重新审视视网膜切除术的概念以及孔源性视网膜脱离（RRD）中视网膜上机械力的理论，并描述放射状视网膜切除术在伴有晚期增生性玻璃体视网膜病变（PVR）的RRD中的潜在应用。
进行文献检索，以确定所有报道使用视网膜切除术治疗伴有PVR的RRD的英文文章。我们回顾了RRD中机械力的理论背景。
视网膜与视网膜色素上皮（RPE）/脉络膜的脱离受多种物理力失衡的影响：视网膜前膜上的切向力和视网膜上的径向牵引力超过视网膜与RPE的粘附力。PVR可能会夸大将视网膜拉开的切向力和径向力的大小。从其切割模式的性质来看，松解性放射状视网膜切除术理论上可能会减少这两种力的大小，从而恢复视网膜表面张力和粘附力之间的平衡。
松解性放射状视网膜切除术可能潜在地应用于伴有晚期PVR的RRD，但迄今为止很少有报道。需要进一步的研究来评估其效果和长期并发症。
