巩膜扣带术中的混合 26G 针引流技术：小巩膜切口。

A hybrid 26G needle drainage technique in scleral buckling: A mini scleral cut-down.

机构信息

Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Indian J Ophthalmol. 2022 Oct;70(10):3603-3606. doi: 10.4103/ijo.IJO_760_22.

DOI:10.4103/ijo.IJO_760_22

PMID:36190054

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9789871/

Abstract

PURPOSE

To evaluate the efficacy and safety of hybrid 26-gauge needle drainage in scleral buckling for rhegmatogenous retinal detachment (RRD).

METHODS

In this retrospective study, we included patients who underwent scleral buckling surgery along with subretinal fluid (SRF) drainage using the 'Hybrid 26G needle drainage technique'. Pre-operative assessment included the best corrected visual acuity (BCVA), lens status, and extent of retinal detachment. Intra-operative surgical details such as the height of retinal detachment, number of attempts required to drain the fluid, amount of fluid drained, adequacy of break buckle relationship, and any intra-operative or post-operative complications were noted. Post-operatively, the final visual outcome and retina status were assessed at 3 months of follow-up.

RESULTS

A total of 10 eyes with primary RRD and proliferative vitreoretinopathy C1 or less were included. Pre-operatively, the mean BCVA was 2.43 ± 1.01 logMAR units, which improved significantly to 0.679 ± 0.45 logMAR units (p value < 0.05) at 3 months of follow-up. Regarding the extent of RRD, five eyes (50%) had a total detachment, two eyes (20%) had a sub-total detachment, and three eyes (30%) had an inferior detachment. Four eyes had shallow detachment, four had a moderate detachment, and two eyes had bullous detachment. Complete drainage of SRF (>75%) was achieved in five patients, and a partial but adequate drainage (50-75%) was achieved in the rest of the five patients. In none of the patients, inadequate or dry tap was encountered. No intra-operative complications were encountered. The retina was attached in eight out of ten eyes at 1 week and at a 1-month follow-up period. Two patients required pars plana vitrectomy for persistent SRF. The retina was attached in all the patients at 3 months of follow-up.

CONCLUSION

The 'Hybrid needle drainage' technique is a safe and effective technique for SRF drainage in scleral buckling surgery.

摘要

目的

评估巩膜扣带术联合视网膜下液（SRF）引流的混合 26 号针引流治疗孔源性视网膜脱离（RRD）的疗效和安全性。

方法

本回顾性研究纳入了接受巩膜扣带术联合使用“混合 26G 针引流技术”进行视网膜下液引流的患者。术前评估包括最佳矫正视力（BCVA）、晶状体状态和视网膜脱离程度。术中手术细节，如视网膜脱离的高度、引流液体所需的尝试次数、引流的液体量、裂孔扣带关系的充分性以及任何术中或术后并发症均被记录。术后，在随访 3 个月时评估最终视力结果和视网膜状态。

结果

共纳入 10 例原发性 RRD 伴增殖性玻璃体视网膜病变 C1 或以下的患者。术前，平均 BCVA 为 2.43±1.01logMAR 单位，术后 3 个月显著提高至 0.679±0.45logMAR 单位（p 值<0.05）。就 RRD 的程度而言，5 只眼（50%）为完全脱离，2 只眼（20%）为次全脱离，3 只眼（30%）为下脱离。4 只眼为浅脱离，4 只眼为中脱离，2 只眼为疱状脱离。5 例患者实现了 SRF 的完全引流（>75%），其余 5 例患者实现了部分但充分的引流（50-75%）。在没有患者遇到引流不充分或干抽的情况。术中无并发症发生。术后 1 周和 1 个月随访时，10 只眼中有 8 只眼视网膜复位。2 例患者因持续 SRF 需要行玻璃体切除术。所有患者在随访 3 个月时视网膜均复位。