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3D可视化系统辅助玻璃体切除术治疗孔源性视网膜脱离:省略全氟碳液

3D Visualization System-Assisted Vitrectomy for Rhegmatogenous Retinal Detachment: Leave Out the Perfluorocarbon Liquid.

作者信息

Guan Lina, Chen Jiayu, Tang Yu, Lu Zhaolin, Zhang Zhengpei, Ji Sujuan, Li Meili, Liu Yalu, Li Suyan, Liu Haiyang

机构信息

The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China.

Department of Ophthalmology, Xuzhou First People's Hospital, Xuzhou, China.

出版信息

Ophthalmol Ther. 2023 Jun;12(3):1611-1619. doi: 10.1007/s40123-023-00692-2. Epub 2023 Mar 4.

Abstract

INTRODUCTION

Pars plana vitrectomy (PPV) is a primary strategy to restore vision for patients who have rhegmatogenous retinal detachment (RRD). Perfluorocarbon liquid (PFCL) is frequently used during PPV surgery. However, the unintended intraocular retention of PFCL may cause retina toxicity and thus lead to possible postoperative complications. In this paper, the experiences and surgical outcomes of a NGENUITY 3D Visualization System-assisted PPV are shown to evaluate the possibility of excluding the application of PFCL.

METHODS

A consecutive series of 60 cases with RRD were presented, all of whom had undergone 23-gauge PPV with the assistance of a three-dimensional (3D) visualization system. Among them, 30 cases used PFCL to assist the drainage of subretinal fluid (SRF), while the other 30 cases did not. Parameters including retinal reattachment rate (RRR), best-corrected visual acuity (BCVA), operation time, and SRF residual were compared between the two groups.

RESULTS

Baseline data showed no statistical significance between the two groups. At the last postoperative follow-up, the RRR of all the 60 cases reached 100% and best-corrected visual acuity (BCVA) gained significant improvement. The BCVA (logMAR) increased from 1.293 ± 0.881 to 0.479 ± 0.316 in the PFCL-excluded group, exhibiting better results than the PFCL included group, whose final BCVA was 0.650 ± 0.371. More importantly, excluding PFCL greatly reduced the operation time (decrease of 20%), therefore, avoiding possible complications caused by both the use of PFCL and the operation process.

CONCLUSION

With the assistance of the 3D visualization system, it is feasible to treat RRD and perform PPV without using PFCL. The 3D visualization system is highly recommendable, as not only can it achieve the same surgical effect without the assistance of PFCL, but also simplify the operation procedure, shorten the operation time, save costs, and avoid complications related to PFCL.

摘要

引言

玻璃体切除术(PPV)是恢复孔源性视网膜脱离(RRD)患者视力的主要策略。全氟碳液体(PFCL)在PPV手术中经常使用。然而,PFCL意外地保留在眼内可能会导致视网膜毒性,从而引发术后并发症。本文展示了在NGENUITY 3D可视化系统辅助下进行PPV的经验和手术结果,以评估排除PFCL应用的可能性。

方法

连续纳入60例RRD患者,所有患者均在三维(3D)可视化系统辅助下接受了23G玻璃体切除术。其中30例使用PFCL辅助视网膜下液(SRF)引流,另外30例未使用。比较两组的视网膜复位率(RRR)、最佳矫正视力(BCVA)、手术时间和SRF残留等参数。

结果

基线数据显示两组之间无统计学意义。术后最后一次随访时,60例患者的RRR均达到100%,最佳矫正视力(BCVA)有显著改善。在不使用PFCL的组中,BCVA(logMAR)从1.293±0.881提高到0.479±0.316,结果优于使用PFCL的组,其最终BCVA为0.650±0.371。更重要的是,排除PFCL大大缩短了手术时间(减少20%),因此避免了使用PFCL和手术过程可能引起的并发症。

结论

在3D可视化系统的辅助下,不使用PFCL治疗RRD并进行PPV是可行的。强烈推荐使用3D可视化系统,因为它不仅可以在不使用PFCL的情况下达到相同的手术效果,还能简化手术操作程序,缩短手术时间,节省成本,并避免与PFCL相关的并发症。

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