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25G 经睫状体平坦部玻璃体切割术联合巩膜环扎带治疗急性视网膜坏死相关孔源性视网膜脱离的疗效。

Outcomes of 25-gauge pars plana vitrectomy with encircling scleral band for acute retinal necrosis-related rhegmatogenous retinal detachment.

机构信息

Department of Ophthalmology, Drishti Eye Hospital, Panchkula, Haryana, India.

Department of Ophthalmology, Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Indian J Ophthalmol. 2021 Mar;69(3):635-640. doi: 10.4103/ijo.IJO_1353_20.

Abstract

PURPOSE

The aim of this study was to evaluate the anatomic and functional outcomes of 25-gauge pars plana vitrectomy (25G PPV) with encircling scleral band (ESB) in patients with acute retinal necrosis (ARN)-related rhegmatogenous retinal detachment (RRD).

METHODS

Single-center retrospective interventional case series of patients who underwent 25G PPV with ESB for ARN-related RRD. Complete anatomic success was defined as the complete attachment of retina after primary PPV. Functional success was measured by the final best-corrected visual acuity (BCVA) ≥20/400. Intraoperative and postoperative complications were also noted.

RESULTS

14 eyes of 13 patients were included in the study. Six patients (46.1%) were immunocompromised. The mean follow-up was 23.64 ± 9.95 (range 6-42) months. Silicone oil was used as tamponade in 13 eyes and CFgas in one eye. After the primary PPV, complete anatomical success was seen in all eyes (100%), however, one eye developed phthisis bulbi after silicone oil removal (SOR). Statistically significant improvement of BCVA was seen, from LogMAR 2.03 ± 0.29 preoperatively to LogMAR 1.57 ± 0.63 postoperatively (p-value 0.014). Six eyes (42.9%) had functional success. Nine eyes (64.3%) had improvement in vision while 4 eyes (28.6%) maintained preoperative vision. 10 eyes (71.4%) underwent cataract surgery, nine eyes (64.3%) underwent SOR while 2 eyes (14.3%) had epiretinal membrane (ERM) under oil during follow-up.

CONCLUSION

25G PPV combines the advantages of minimally invasive vitrectomy surgery while offering improved anatomic outcomes in patients with ARN-related RRD. The functional outcome varies depending on the status of the optic disc and macula.

摘要

目的

本研究旨在评估 25G 经睫状体平坦部玻璃体切除术(25G PPV)联合巩膜环扎带(ESB)治疗急性视网膜坏死(ARN)相关孔源性视网膜脱离(RRD)的解剖和功能结果。

方法

单中心回顾性病例系列研究,纳入了接受 25G PPV 联合 ESB 治疗 ARN 相关 RRD 的患者。完全解剖成功定义为初次 PPV 后视网膜完全贴附。功能成功通过最终最佳矫正视力(BCVA)≥20/400 来衡量。还记录了术中及术后并发症。

结果

本研究纳入了 13 例患者的 14 只眼。6 例患者(46.1%)存在免疫抑制。平均随访时间为 23.64±9.95 个月(范围 6-42 个月)。13 只眼使用硅油作为眼内填充物,1 只眼使用 C3F8 气体。初次 PPV 后,所有眼(100%)均达到完全解剖成功,但 1 只眼在硅油取出(SOR)后发生眼球萎缩。术后 BCVA 显著改善,从术前的 LogMAR 2.03±0.29 提高至术后的 LogMAR 1.57±0.63(p 值=0.014)。6 只眼(42.9%)获得功能成功。9 只眼(64.3%)视力提高,4 只眼(28.6%)保持术前视力。10 只眼(71.4%)行白内障手术,9 只眼(64.3%)行 SOR,2 只眼(14.3%)硅油下存在眼内膜(ERM)。

结论

25G PPV 结合了微创玻璃体切除术的优势,为 ARN 相关 RRD 患者提供了更好的解剖学结果。功能结果取决于视盘和黄斑的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f868/7942078/f58ecf4a82bd/IJO-69-635-g001.jpg

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