Rani Deeksha, Kumar Atul, Chandra Parijat, Chawla Rohan, Hasan Nasiq, Agarwal Divya
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Indian J Ophthalmol. 2021 Feb;69(2):320-325. doi: 10.4103/ijo.IJO_1720_20.
To compare the outcomes of vitreoretinal surgery in patients with primary and recurrent rhegmatogenous retinal detachment (RRD) with proliferative vitreoretinopathy (PVR) on 3 dimensional digitally assisted visualization system (3D-DAVS) and conventional analogue microscope (CAM).
68 patients with primary (50) and recurrent (18) RRD with PVR > C1 were included. One group underwent surgery on 3D-DAVS while the other on CAM. The parameters studied included detachment rate, best-corrected visual acuity (BCVA), duration of surgery, mean endo-illumination levels of 23 G (Gauge) micro incision vitrectomy system (MIVS) and microscope and satisfaction of surgeon and observers based on a framed questionnaire. The mean duration of follow up was three months.
68 eyes of 68 patients with median age 52.5 (range 18-68) years were included. 50 had primary RRD and 18 had recurrent RRD. Detachment rate at the end of three months was comparable in both groups of primary (P > 0.99) and recurrent (P = 0.21) RRD. Mean duration of surgery in minutes for 3D DAVS and CAM group was 61.8 (±22.07) and 58.04 (±12.33), respectively, in primary RRD and 37.22 (±10.27) and 36.55 (±5.92), respectively, in recurrent RRD group. Mean endo-illumination in 3D DAVS (14.5%) group was half of that in CAM (34.17%) group. Surgeon and observer satisfaction scores were significantly higher for 3D DAVS group.
3D DAVS is a safe and effective modality or performing VR surgery in RRD with PVR. 3D DAVS allows lower endo-illumination levels provides superior surgeon ergonomics and offers better learning opportunities to the trainees.
比较在三维数字辅助可视化系统(3D-DAVS)和传统模拟显微镜(CAM)下,原发性和复发性孔源性视网膜脱离(RRD)伴增生性玻璃体视网膜病变(PVR)患者的玻璃体视网膜手术效果。
纳入68例原发性(50例)和复发性(18例)RRD且PVR>C1的患者。一组在3D-DAVS下进行手术,另一组在CAM下进行手术。研究的参数包括脱离率、最佳矫正视力(BCVA)、手术时长、23G(规格)微创玻璃体切割系统(MIVS)和显微镜的平均眼内照明水平,以及基于结构化问卷的术者和观察者满意度。平均随访时长为三个月。
纳入68例患者的68只眼,中位年龄52.5岁(范围18-68岁)。50例为原发性RRD,18例为复发性RRD。原发性RRD和复发性RRD两组在三个月末的脱离率相当(原发性P>0.99,复发性P=0.21)。在原发性RRD中,3D DAVS组和CAM组的平均手术时长(分钟)分别为61.8(±22.07)和58.04(±12.33),在复发性RRD组中分别为37.22(±10.27)和36.55(±5.92)。3D DAVS组(14.5%)的平均眼内照明是CAM组(34.17%)的一半。3D DAVS组的术者和观察者满意度评分显著更高。
3D DAVS是一种安全有效的方式,可用于对伴PVR的RRD进行玻璃体视网膜手术。3D DAVS允许更低的眼内照明水平,提供更好的术者人体工程学条件,并为学员提供更好的学习机会。