Safadi Khaled, Chowers Itay, Khateb Samer
Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Acta Ophthalmol. 2021 Dec;99(8):892-897. doi: 10.1111/aos.14783. Epub 2021 Feb 4.
To evaluate the functional and anatomical outcomes of primary rhegmatogenous retinal detachment (RRD) repair in young adults.
A retrospective, comparative case series study. Patients between the ages of 18 and 40 years who underwent surgical repair of primary RRD between the years 2006 and 2013 were included. Patients were divided into three groups according to the surgical technique used: scleral buckle (SB), pars plana vitrectomy (PPV) or combined surgery (SB-PPV).
Ninety eyes (90 patients) were included. The mean age (SD) was 31.5 ± 5.1 years (range 22-40). Sixty-seven patients underwent SB, 10 had PPV and 13 had SB-PPV. Anatomical success rates were similar between the three groups (87%, 90% and 85% for SB, PPV and SB-PPV groups, respectively; p-value = 0.9). Mean (SD) preoperative LogMAR visual acuity (VA) was 0.46 ± 0.6, 1.73 ± 1.1, 1.1 ± 1.1 for SB, PPV and SB-PPV groups, respectively (p < 0.0001). The VA improved at last follow-up to 0.23 ± 0.4, 0.7 ± 1.5 and 1.09 ± 1.08 in SB, PPV and SB-PPV groups, respectively (p < 0.0001). Macula-off was diagnosed in 19.4% of SB, 80% of PPV and 53.9% of SB-PPV groups (p < 0.0001). In the SB group one phakic patient (1.5%) needed cataract extraction, while following PPV, all phakic eyes (100%) underwent cataract extraction eventually (p-value < 0.0001).
The study emphasizes the efficacy of SB as a primary procedure for the repair of retinal detachment in young adults in terms of anatomical and functional success. Furthermore, preservation of the lens as a result of using SB rather than PPV when possible is of great importance in this age group.
评估年轻成年人原发性孔源性视网膜脱离(RRD)修复手术的功能和解剖学效果。
一项回顾性、对比性病例系列研究。纳入2006年至2013年间接受原发性RRD手术修复的18至40岁患者。根据所采用的手术技术将患者分为三组:巩膜扣带术(SB)、玻璃体切除术(PPV)或联合手术(SB-PPV)。
共纳入90只眼(90例患者)。平均年龄(标准差)为31.5±5.1岁(范围22 - 40岁)。67例患者接受了SB手术,10例接受了PPV手术,13例接受了SB-PPV手术。三组的解剖学成功率相似(SB组、PPV组和SB-PPV组分别为87%、90%和85%;p值 = 0.9)。SB组、PPV组和SB-PPV组术前平均(标准差)对数最小分辨角视力(VA)分别为0.46±0.6、1.73±1.1、1.1±1.1(p < 0.0001)。在最后一次随访时,SB组、PPV组和SB-PPV组的VA分别改善至0.23±0.4、0.7±1.5和1.09±1.08(p < 0.0001)。SB组19.4%、PPV组80%和SB-PPV组53.9%的患者诊断为黄斑脱离(p < 0.0001)。SB组1例有晶状体眼患者(1.5%)需要行白内障摘除术,而PPV术后,所有有晶状体眼(100%)最终都接受了白内障摘除术(p值 < 0.0001)。
该研究强调了SB作为年轻成年人视网膜脱离修复的主要手术方法在解剖学和功能方面的有效性。此外,在这个年龄组中,尽可能使用SB而非PPV以保留晶状体非常重要。