Rani Padmaja K, Narayanan Raja, Deshpande Riddhima S, Balakrishnan Divya, Ali Mohammad H
Vitreoretinal Diseases and Teleophthalmology, LV Prasad Eye Institute, Hyderabad, IND.
Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, IND.
Cureus. 2020 Nov 19;12(11):e11579. doi: 10.7759/cureus.11579.
Purpose The aim of the article is to compare scleral buckle (SB) and primary sutureless pars plana vitrectomy (PPV) without SB in rhegmatogenous retinal detachment (RRD) repair. Methods A retrospective study of rhegmatogenous RD surgeries performed between eyes with proliferative vitreoretinopathy (PVR) up to grade B and a minimum of two months postoperative follow-up were included. The primary outcome measure was an improvement in the final best-corrected visual acuity (BCVA) and secondary outcome measures were a final anatomical success, number of resurgeries, and cataract progression. Results A total of 37 eyes in the SB group and 30 eyes in the sutureless PPV group were included. The mean follow-up was 7.5 ± 5 months and 9 ± 4 months in the SB and PPV group, respectively. The improvement in the final BCVA from baseline was four lines in the SB group and five lines in the PPV group (p=0.87). The final anatomical success was 97% in SB and 93% in the PPV group. The number of re-surgeries for attachment of retina were higher in the PPV group, (SB: 8/37 vs PPV: 8/30 p=0.03).The number of resurgeries (16/37 vs. 33/30; p=<0.05), cataract progression (3/37 vs. 10/30; p=0.01), and the mean number of hospital visits (6 vs. 9; p=0.001) were significantly higher in the sutureless PPV group. Conclusions Visual acuity improvement and anatomical success rates were similar between SB and sutureless PPV in RRD repair. The number of operations, cataract progression, and the mean number of hospital visits were higher in the sutureless PPV group.
目的 本文旨在比较巩膜扣带术（SB）与不联合SB的原发性无缝合玻璃体切除术（PPV）在孔源性视网膜脱离（RRD）修复中的效果。方法 对增生性玻璃体视网膜病变（PVR）B级及以下的RRD手术进行回顾性研究，纳入至少术后随访2个月的患者。主要观察指标为最终最佳矫正视力（BCVA）的改善情况，次要观察指标为最终解剖学成功、再次手术次数和白内障进展情况。结果 SB组共纳入37只眼，无缝合PPV组共纳入30只眼。SB组和PPV组的平均随访时间分别为7.5±5个月和9±4个月。SB组最终BCVA较基线提高了4行，PPV组提高了5行（p=0.87）。SB组最终解剖学成功率为97%，PPV组为93%。PPV组视网膜复位的再次手术次数更高（SB组：8/37 vs PPV组：8/30，p=0.03）。无缝合PPV组的再次手术次数（16/37 vs. 33/30；p<0.05）、白内障进展（3/37 vs. 10/30；p=0.01）以及平均住院次数（6 vs. 9；p=0.001）均显著更高。结论 在RRD修复中，SB与无缝合PPV的视力改善和解剖学成功率相似。无缝合PPV组的手术次数、白内障进展和平均住院次数更高。
