玻璃体切除术后眼复发性视网膜脱离行巩膜扣带术联合或不联合气体填塞的效果

Outcome of scleral buckling with or without gas tamponade for recurrent retinal detachment in post-vitrectomy eyes.

作者信息

Bai Jun-Xing, Zhang Xiao-Jian, Duan An-Li, Peng Xiao-Yan

机构信息

Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmolgy and Visual Science Key Laboratory, No.17 Hougou Lane, Chongnei Street, Beijing, 100005, People's Republic of China.

Department of Ophthalmology, Beijing Meiermu Hospital, No.65 Fuxing Road, Haidian District, Beijing, 100036, People's Republic of China.

出版信息

BMC Ophthalmol. 2021 Feb 27;21(1):109. doi: 10.1186/s12886-021-01873-y.

DOI:10.1186/s12886-021-01873-y

PMID:33639899

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7916288/

Abstract

BACKGROUND

Treatment of recurrent retinal detachment (re-RD) following vitrectomy (post-gas/air tamponade and post-silicone oil removal) is challenging. Previously reported treatment is commonly revision pars plana vitrectomy (PPV) combined with tamponade, which is invasive and a burden both economically and emotionally when compared with scleral buckling (SB). The purpose of this study is to report anatomical and functional outcomes of SB with or without gas tamponade in eyes with recurrent retinal detachment (re-RD) that previously underwent PPV at least once.

METHODS

We retrospectively reviewed the medical records of 14 patients (14 eyes) who underwent PPV at least once and were treated with SB after re-RD. Preoperative characteristics, intraoperative complications, and postoperative data were assessed. The final anatomical and functional outcomes were analyzed.

RESULTS

The original PPV was performed for primary rhegmatogenous retinal detachment in 11 eyes, macular hole retinal detachment in 2 eyes, and myopic foveoschisis in 1 eye. Previously, 3 eyes underwent one PPV with gas tamponade, and the remaining 11 (79%) eyes underwent 2-5 operations. Seven eyes underwent the procedure with gas injection. At the last follow-up, 13 eyes achieved total retinal attachment and 1 eye had re-RD. The postoperative intraocular pressure was within the normal range, except in 1 eye (6 mmHg). The finest postoperative best-corrected visual acuity (BCVA) was 20/25. There was a significant improvement in BCVA from 20/160 ± 20/63 at baseline to 20/80 ± 20/50 at the last visit in the 13 successfully treated eyes (P = 0.025).

CONCLUSIONS

SB can be effective for re-RD after PPV in specific cases.

摘要

背景

玻璃体切除术后（气体/空气填塞后及硅油取出后）复发性视网膜脱离（re-RD）的治疗具有挑战性。先前报道的治疗方法通常是改良的玻璃体切除术（PPV）联合填塞，与巩膜扣带术（SB）相比，这种方法具有侵入性，在经济和情感上都是一种负担。本研究的目的是报告在先前至少接受过一次PPV的复发性视网膜脱离（re-RD）眼中，巩膜扣带术联合或不联合气体填塞的解剖和功能结果。

方法

我们回顾性分析了14例（14只眼）至少接受过一次PPV且在复发性视网膜脱离后接受巩膜扣带术治疗的患者的病历。评估术前特征、术中并发症和术后数据。分析最终的解剖和功能结果。

结果

最初的PPV用于治疗11只眼的原发性孔源性视网膜脱离、2只眼的黄斑裂孔性视网膜脱离和1只眼的近视性黄斑劈裂。此前有3只眼接受了一次PPV联合气体填塞，其余11只眼（79%）接受了2至5次手术。7只眼在手术中进行了气体注射。在最后一次随访时，13只眼实现了视网膜完全复位，1只眼出现了复发性视网膜脱离。除1只眼（眼压为6mmHg）外，术后眼压均在正常范围内。术后最佳矫正视力（BCVA）最好为20/25。13只成功治疗的眼的BCVA从基线时的20/160±20/63显著提高到最后一次随访时的20/80±20/50（P = 0.025）。