University Medical Center, Departrment of Ophthalmology, University of Hamburg, Hamburg, Germany.
University Medical Center, Departrment of Ophthalmology, University of Hamburg, Hamburg, Germany
Br J Ophthalmol. 2023 Nov 22;107(12):1900-1906. doi: 10.1136/bjo-2022-321640.
To determine differences in postoperative pupil diameter in eyes that undergo pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) with endolaser retinopexy (ELR), comparing 360° vs focal ELR.
Patients with uncomplicated RRD who underwent PPV were prospectively analysed regarding the postoperative pupil diameter difference (PDD) between the affected eye and the partner eye. Group 1 underwent 360° ELR and group 2 received focal ELR. Postoperative vision and complications, including redetachment rate, macular oedema and epiretinal membrane formation, were also compared.
A total of 72 patients, 42 in group 1 and 30 in group 2, were analysed. PDD, as observed at 6 weeks, was significantly greater than the preoperative values in both groups 1 and 2. It increased by a mean of 1±1.11 mm in group 1 and by 0.5±0.78 in group 2. This initial increase in PDD receded over time, but remained statistically significant in both groups, even at 6 months. The top 20% of patients with the largest PDD change comprised 13 out of 15 eyes from group 1, which was a statistically significant overrepresentation (p=0.0435).
Moderate pupillotonia was induced post-ELR in vitrectomy and correlated to the extent of ELR. The pupillotonia effect of ELR was significantly less marked in pseudophakic eyes.
比较巩膜外冷凝视网膜光凝术（ELR）的 360° 与局灶性 ELR，确定孔源性视网膜脱离（RRD）行玻璃体切除术（PPV）后瞳孔直径的差异。
对接受 PPV 治疗的单纯性 RRD 患者进行前瞻性分析，比较患眼和对侧眼术后瞳孔直径差（PDD）。组 1 行 360°ELR，组 2 行局灶性 ELR。比较术后视力和并发症，包括复发率、黄斑水肿和视网膜前膜形成。
共分析了 72 例患者，其中 42 例在组 1，30 例在组 2。术后 6 周，两组 PDD 均明显大于术前值。组 1 增加了 1±1.11mm，组 2 增加了 0.5±0.78mm。这种 PDD 的初始增加随着时间的推移而消退，但在两组中仍具有统计学意义，甚至在 6 个月时也是如此。PDD 变化最大的前 20%患者中，有 13 只眼来自组 1，这具有统计学显著意义（p=0.0435）。
巩膜外冷凝视网膜光凝术后会出现瞳孔中度扩大，与 ELR 的范围有关。白内障眼中 ELR 的瞳孔扩大效应明显较小。
