Mahmoudzadeh Raziyeh, Huang Denis, Salabati Mirataollah, Awh Katherine, Garg Sunir, Hsu Jason, Ho Allen, Regillo Carl
Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
J Vitreoretin Dis. 2021 Jul 9;5(5):405-411. doi: 10.1177/24741264211024127. eCollection 2021 Sep-Oct.
This work assesses the clinical characteristics and outcomes of various treatment methods in managing rhegmatogenous retinal detachments secondary to retinal dialysis.
In this retrospective, consecutive case series, patients presenting to a tertiary referral vitreoretinal service from 2015 to 2020 were chosen. The primary outcome measure was the single-surgery anatomic success (SSAS) rate in the first 90 days after surgery and overall SSAS rate until the last visit.
Eighty-six eyes of 84 patients were included. Mean (SD) age was 30 (14.8) years (range, 7-71 years). Fifty-nine (70%) patients were men and 55 eyes (64%) had a history of trauma. Dialysis occurred in the inferotemporal quadrant in 50 eyes (58%) of the entire cohort and 25 of 55 eyes (45%) with prior trauma. Fifty-one eyes (59.3%) were managed by scleral buckle (SB), 25 eyes (29.2%) with laser retinopexy, and 10 eyes (11.6%) with pars plana vitrectomy (PPV). The SSAS rate in the first 90 days after surgery was 94.1% (81 of 86 eyes), including 90.1% of eyes with SB, 100% of eyes with laser retinopexy, and 100% of eyes with PPV ( = .07). The overall SSAS rate, however, was 89.5% (77 of 86) eyes, including 90.1% of eyes with SB, 84% of eyes with laser retinopexy, and 100% of eyes with PPV ( = .4). Final attachment rate was 100% in the entire cohort.
With careful consideration of underlying pathology, all 3 treatment modalities can provide high rates of anatomic and functional success.
本研究评估了各种治疗方法在处理视网膜透析继发的孔源性视网膜脱离时的临床特征及治疗效果。
在这个回顾性的连续病例系列研究中，选取了2015年至2020年在一家三级转诊玻璃体视网膜服务机构就诊的患者。主要观察指标为术后前90天的单次手术解剖成功（SSAS）率以及直至最后一次随访时的总体SSAS率。
纳入了84例患者的86只眼。平均（标准差）年龄为30（14.8）岁（范围7至71岁）。59例（70%）患者为男性，55只眼（64%）有外伤史。在整个队列中，50只眼（58%）的视网膜透析发生在颞下象限，在55只曾有外伤的眼中，25只眼（45%）的视网膜透析发生在颞下象限。51只眼（59.3%）采用巩膜扣带术（SB）治疗，25只眼（29.2%）采用激光视网膜光凝术治疗，10只眼（11.6%）采用玻璃体切割术（PPV）治疗。术后前90天的SSAS率为94.1%（86只眼中的81只），其中采用SB治疗的眼为90.1%，采用激光视网膜光凝术治疗的眼为100%，采用PPV治疗 的眼为100%（P = 0.07）。然而，总体SSAS率为89.5%（86只眼中的77只），其中采用SB治疗的眼为90.1%，采用激光视网膜光凝术治疗的眼为84%，采用PPV治疗的眼为100%（P = 0.4）。整个队列的最终复位率为100%。
在仔细考虑潜在病理情况后，所有这三种治疗方式均可实现较高的解剖和功能成功率。
