Department of Ophthalmology, Drishti Eye Hospital, Panchkula, Haryana, India.
Department of Ophthalmology, Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Ophthalmol. 2021 Mar;69(3):635-640. doi: 10.4103/ijo.IJO_1353_20.
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).
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.
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.
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.
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。
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。
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）。
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。
