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无晶状体切除术的视网膜切除术治疗伴有增生性玻璃体视网膜病变的孔源性视网膜脱离的疗效

Outcomes of Retinectomy without Lensectomy in Rhegmatogenous Retinal Detachments with Proliferative Vitreoretinopathy.

作者信息

Mahmoudzadeh Raziyeh, Mokhashi Nikita, Anderson Hannah, Patel Shail, Salabati Mirataollah, Chiang Allen, Kuriyan Ajay E, Gupta Omesh P, Mehta Sonia, Garg Sunir J, Hsu Jason

机构信息

Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania.

Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.

出版信息

Ophthalmol Retina. 2023 Jan;7(1):52-58. doi: 10.1016/j.oret.2022.07.008. Epub 2022 Aug 5.

Abstract

PURPOSE

To report the anatomic and functional outcomes of retinectomy without lensectomy in eyes with rhegmatogenous retinal detachment (RRD) and proliferative vitreoretinopathy (PVR).

DESIGN

Retrospective, noncomparative, and interventional case series.

SUBJECTS

One hundred twelve eyes of 112 patients with RRD complicated by PVR who underwent retinectomy without lensectomy.

METHODS

Retrospective review of patients treated with vitrectomy and retinectomy without lensectomy from January 1, 2015, to January 1, 2020.

MAIN OUTCOME MEASURES

The primary outcome was the final attachment rate and single surgery anatomic success (SSAS) at 3 and 6 months after retinectomy. Secondary outcomes included predictors of final visual acuity (VA), the mean number of subsequent operations required for complete retinal reattachment, cataract surgery, and the number of eyes that ultimately had successful silicone oil removal.

RESULTS

Complete final retinal reattachment was achieved in 111 of 112 (99.1%) patients, with a mean (standard deviation [SD]) follow-up of 29 (14) months (range, 8-62 months) after retinectomy. The SSAS was achieved in 84 of 112 (75%) patients at 3 months and 73 of 112 (65.2%) patients at 6 months. The final VA improved or stabilized in 76 of 112 (67.9%) eyes. Silicone oil removal was performed in 72 of 112 patients (64.3%) at a mean (SD) of 6.6 (3.3) months, and cataract surgery was performed on 101 (90.2%) eyes before the last follow-up visit.

CONCLUSIONS

Retinectomy without lensectomy to repair RRDs complicated by PVR showed acceptable anatomic and functional results. This study suggests that removing the lens when there is no significant cataract may not be necessary in these cases to obtain reasonable outcomes.

摘要

目的

报告孔源性视网膜脱离(RRD)合并增殖性玻璃体视网膜病变(PVR)患者行视网膜切除术而未行晶状体切除术的解剖和功能结果。

设计

回顾性、非对照性干预病例系列。

研究对象

112例RRD合并PVR患者的112只眼,这些患者接受了视网膜切除术而未行晶状体切除术。

方法

回顾性分析2015年1月1日至2020年1月1日期间接受玻璃体切除术和视网膜切除术而未行晶状体切除术的患者。

主要观察指标

主要观察指标为视网膜切除术后3个月和6个月时的最终复位率和单次手术解剖成功率(SSAS)。次要观察指标包括最终视力(VA)的预测因素、视网膜完全复位所需的后续手术平均次数、白内障手术以及最终成功取出硅油的眼数。

结果

112例患者中的111例(99.1%)实现了视网膜最终完全复位,视网膜切除术后平均(标准差[SD])随访29(14)个月(范围8 - 62个月)。3个月时,112例患者中的84例(75%)实现了SSAS,6个月时,112例患者中的73例(65.2%)实现了SSAS。112只眼中的76只(67.9%)眼的最终视力得到改善或稳定。112例患者中的72例(64.3%)在平均(SD)6.6(3.3)个月时进行了硅油取出术,101只眼(90.2%)在最后一次随访前进行了白内障手术。

结论

对于RRD合并PVR患者行视网膜切除术而未行晶状体切除术,显示出可接受的解剖和功能结果。本研究表明,在这些病例中,如果没有明显白内障,可能无需摘除晶状体即可获得合理结果。

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