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现代小切口玻璃体切割术时代原发性非复杂性孔源性视网膜脱离的手术修复

Surgical repair of primary non-complex rhegmatogenous retinal detachment in the modern era of small-gauge vitrectomy.

作者信息

Moinuddin Omar, Abuzaitoun Rebhi O, Hwang Min W, Sathrasala Sanjana K, Chen Xing D, Stein Joshua D, Johnson Mark W, Zacks David N, Wubben Thomas J, Besirli Cagri G

机构信息

Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA.

出版信息

BMJ Open Ophthalmol. 2021 Feb 25;6(1):e000651. doi: 10.1136/bmjophth-2020-000651. eCollection 2021.

Abstract

OBJECTIVE

To report anatomic and visual outcomes of pars plana vitrectomy (PPV), as well as scleral buckling (SB) and PPV/SB as surgical treatments for the management of primary, non-complex rhegmatogenous retinal detachment (RRD).

METHODS AND ANALYSIS

Data from 751 eyes that underwent PPV, SB or combined PPV/SB as a surgical treatment for primary non-complex RRD with at least 3 months of follow-up were analysed to determine rates of single surgery anatomic success (SSAS) and final anatomic success (FAS). Patients or the public were not involved in the design, conduct or reporting of this research.

RESULTS

PPV accounted for 89.0% (n=668), PPV/SB for 6.8% (n=51) and SB for 4.2% (n=32) cases. Overall SSAS (91.2% PPV, 84.3% PPV/SB, 93.8% SB; p=0.267) and FAS (96.7% PPV, 94.1% PPV/SB and 100.0% SB; p=0.221) were reported for the three surgical groups. SSAS and FAS were similar for lens status, macular detachment status and the presence or absence of inferior retinal breaks for each of the PPV, PPV/SB and SB groups.

CONCLUSIONS

In this large, single institution, retrospective case series, we report surgical outcomes for patients with primary non-complex RRD managed with PPV, SB or PPV/SB in the modern era of small-gauge vitrectomy. We demonstrate that primary PPV without adjunct SB provides excellent anatomic and visual outcomes irrespective of lens status, macular involvement or pathology location.

摘要

目的

报告玻璃体切割术(PPV)、巩膜扣带术(SB)以及PPV联合SB作为原发性、非复杂性孔源性视网膜脱离(RRD)手术治疗方法的解剖学和视觉效果。

方法与分析

分析751只接受PPV、SB或联合PPV/SB手术治疗原发性非复杂性RRD且至少随访3个月的眼睛的数据,以确定单次手术解剖学成功率(SSAS)和最终解剖学成功率(FAS)。患者或公众未参与本研究的设计、实施或报告。

结果

PPV占89.0%(n = 668),PPV/SB占6.8%(n = 51),SB占4.2%(n = 32)。报告了三个手术组的总体SSAS(PPV为91.2%,PPV/SB为84.3%,SB为93.8%;p = 0.267)和FAS(PPV为96.7%,PPV/SB为94.1%,SB为100.0%;p = 0.221)。PPV、PPV/SB和SB组中,晶状体状态、黄斑脱离状态以及视网膜下方裂孔的有无,其SSAS和FAS相似。

结论

在这个大型单机构回顾性病例系列中,我们报告了在现代小切口玻璃体切割术时代,采用PPV、SB或PPV/SB治疗原发性非复杂性RRD患者的手术结果。我们证明,无论晶状体状态、黄斑受累情况或病变位置如何,不联合SB的原发性PPV均可提供出色的解剖学和视觉效果。

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