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玻璃体皮质残余物与原发性孔源性视网膜脱离玻璃体切除术的解剖学结果之间存在关联吗?

Is There a Link Between Vitreous Cortex Remnants and Anatomic Outcome of Vitrectomy for Primary Rhegmatogenous Retinal Detachment?

作者信息

Assi Alexandre, Mansour Ahmad M, Charbaji Abdul Razzak, Battaglia Parodi Maurizio

机构信息

Beirut Eye Clinic and VitreoRetinal Department, Beirut Eye Specialist Hospital, Beirut, Lebanon.

Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.

出版信息

Clin Ophthalmol. 2023 May 29;17:1489-1496. doi: 10.2147/OPTH.S408871. eCollection 2023.

Abstract

PURPOSE

To study the anatomic outcome of leaving vitreous cortex remnants (VCR) during pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD).

METHODS

The study comprised patients with RRD who had PPV by a single surgeon between January 2019 and December 2020 and followed for 6 months. After intravitreal injection of triamcinolone acetonide, the topographic pattern of VCR at the periphery (p) and macula (m) was divided into 2 types by extent: complete or 4 quadrants (pVCR4Q), andbetween 2 and 4 quadrants ≥2 quadrants (pVCR>2Q), or by location >1 inferior retinal quadrant (pVCR>1InfQ), and at the macula (mVCR). Anatomical failure or retinal re-detachment within 6 months after surgery was the primary outcome measures. The occurrence of grade C proliferative vitreoretinopathy (PVR) and epiretinal membrane (ERM) were used as secondary outcome indicators.

RESULTS

A 6-month prospective follow-up was performed on 103 patients. pVCR4Q was detected in 31 eyes, pVCR>2Q in 40 eyes, pVCR>1InfQ in 40 eyes and mVCR in 54 eyes. Recurrent RRD developed in 9 (8.7%) eyes, PVR grade C in 6 (5.8%) eyes and ERM in 11 (10.7%) eyes. According to multivariate regression analysis, the existence of any type of VCR did not correlate with anatomical failure, PVR or ERM.

CONCLUSION

The initial success rate of PPV and the growth of PVR or ERM do not appear to be impacted by keeping VCR.

摘要

目的

研究在原发性孔源性视网膜脱离(RRD)的玻璃体切割术(PPV)中保留玻璃体皮质残余物(VCR)的解剖学结果。

方法

该研究纳入了2019年1月至2020年12月期间由同一位外科医生进行PPV并随访6个月的RRD患者。玻璃体内注射曲安奈德后,根据范围将周边部(p)和黄斑部(m)VCR的地形图模式分为2种类型:完全或4个象限(pVCR4Q),以及2至4个象限≥2个象限(pVCR>2Q),或根据位置>1个视网膜下象限(pVCR>1InfQ),以及黄斑部(mVCR)。手术6个月内的解剖学失败或视网膜再脱离是主要结局指标。C级增殖性玻璃体视网膜病变(PVR)和视网膜前膜(ERM)的发生作为次要结局指标。

结果

对103例患者进行了6个月的前瞻性随访。31只眼中检测到pVCR4Q,40只眼中检测到pVCR>2Q,40只眼中检测到pVCR>1InfQ,54只眼中检测到mVCR。9只眼(8.7%)发生复发性RRD,6只眼(5.8%)发生C级PVR,11只眼(10.7%)发生ERM。根据多因素回归分析,任何类型的VCR的存在与解剖学失败、PVR或ERM均无相关性。

结论

保留VCR似乎不会影响PPV的初始成功率以及PVR或ERM的发生。

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