Radeck Viola, Helbig Horst, Prahs Philipp
Augenklinik und Poliklinik, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
Ophthalmologe. 2022 Apr;119(4):381-387. doi: 10.1007/s00347-021-01485-3. Epub 2021 Aug 30.
Full-thickness retinal folds are an unpleasant complication after vitrectomy or buckle surgery with gas tamponade for the treatment of retinal detachment. If the retinal folds involve the macula, the visual function of the patients will be severely impaired. This article describes a surgical technique for the management of such full-thickness macular folds.
Between January 2017 and June 2020 a total of 6 patients were treated with the following technique. A redetachment was induced with balanced salt solution (BSS), followed by a subretinal air injection with filtered air. The retinal fold was mechanically smoothed out with the aid of perfluorocarbon (PFC). A postoperative drainage of air and BSS was not necessary due to spontaneous resorption.
None of the patients experienced visual loss after redetachment of the retina. The visual acuity improved in 4 of the 6 patients, perception of metamorphopsia improved in 5 out of 6 patients, 2 reported complete disappearance of metamorphopsia and in 1 patient distorted vision was unchanged despite an anatomically smoothed central retina after surgery.
With careful consideration of the indications, this surgical technique has shown to be a safe and promising therapeutic strategy for the treatment of macular full-thickness retinal folds after retinal detachment surgery.
全层视网膜皱襞是玻璃体切除术或巩膜扣带术联合气体填充治疗视网膜脱离后令人不快的并发症。如果视网膜皱襞累及黄斑，患者的视功能将严重受损。本文描述了一种治疗此类全层黄斑皱襞的手术技术。
2017年1月至2020年6月，共有6例患者接受了以下技术治疗。用平衡盐溶液（BSS）诱导视网膜再脱离，然后向视网膜下注入过滤空气。借助全氟碳（PFC）将视网膜皱襞机械性抚平。由于气体可自行吸收，术后无需排出空气和BSS。
视网膜再脱离后，所有患者均未出现视力丧失。6例患者中有4例视力提高，6例中有5例视物变形感改善，2例报告视物变形完全消失，1例患者尽管术后中央视网膜在解剖学上已变平，但视力仍未改变。
在仔细考虑适应证的情况下，该手术技术已被证明是治疗视网膜脱离手术后黄斑全层视网膜皱襞的一种安全且有前景的治疗策略。
