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孔源性视网膜脱离的微创玻璃体切割术的治疗效果

Outcomes Of Microincision Pars Plana Vitrectomy In Rhegmatogenous Retinal Detachment.

作者信息

Subedi Santosh, Thapa Raba, Pradhan Eli, Bajiyama Sanyam, Sharma Sanjita, Duwal Sushma, Poudel Manish, Poudyal Govinda

机构信息

Tilganga Institute of Ophthalmology, Kathmandu, Nepal.

出版信息

J Nepal Health Res Counc. 2023 Jul 20;20(4):983-987. doi: 10.33314/jnhrc.v20i4.4417.

Abstract

BACKGROUND

With the technological advances, microincision pars plana vitrectomy is commonly used method for primary treatment of eyes with rhegmatogenous retinal detachment. Objective of this study is to evaluate anatomical and visual outcomes of microincision pars plana vitrectomy in eyes with rhegmatogenous retinal detachment.

METHODS

This was a hospital based prospective observational study done in Tilganga Institute of Ophthalmology, Kathmandu, Nepal. All consecutive cases of rhegmatogenous retinal detachment who underwent primary microincision pars plana vitrectomy from October 2020 to March 2021 were included in the study. Patients were evaluated at baseline, postoperative day 1, 1 week, 6 weeks and 3 months. Outcome measures evaluated were anatomical results, visual outcomes and complications of the surgery.

RESULTS

Forty-nine eyes with rhegmatogenous retinal detachment treated with primary microincision pars plana vitrectomy with minimum follow up of at least 3 months were evaluated. Anatomical success was achieved in 91.8% of cases (45/49). Baseline mean best corrected visual acuity was logMAR 1.63±0.88 and median best corrected visual acuity was 2.00 (range 0.00 to 2.70) while at 3 months follow up mean best corrected visual acuity was logMAR 1.22±0.66 and median BCVA was 1.00 ( range 0.00 to 2.70). There was significant improvement in median BCVA ( p= 0.005). There were no cases of postoperative hypotony and endophthalmitis. Other complications were also minimal such as silicon oil in anterior chamber in 1 eye, epiretinal membrane in 3 eyes and macular hole in 2 eyes.

CONCLUSIONS

Microincision pars plana vitrectomy is an effective surgical method of primary treatment for rhegmatogenous retinal detachment with good anatomical and visual outcomes with minimal complications.

摘要

背景

随着技术进步,微创玻璃体切割术是孔源性视网膜脱离患者主要的初始治疗方法。本研究旨在评估微创玻璃体切割术治疗孔源性视网膜脱离患者的解剖和视觉效果。

方法

这是一项在尼泊尔加德满都蒂尔冈加眼科研究所进行的基于医院的前瞻性观察研究。纳入2020年10月至2021年3月期间接受初次微创玻璃体切割术的所有连续性孔源性视网膜脱离病例。在基线、术后第1天、1周、6周和3个月对患者进行评估。评估的结果指标包括手术的解剖结果、视觉效果和并发症。

结果

对49例接受初次微创玻璃体切割术且至少随访3个月的孔源性视网膜脱离患者的眼部进行了评估。91.8%的病例(45/49)获得了解剖学成功。基线时平均最佳矫正视力为logMAR 1.63±0.88,最佳矫正视力中位数为2.00(范围0.00至2.70),而在3个月随访时,平均最佳矫正视力为logMAR 1.22±0.66,最佳矫正视力中位数为1.00(范围0.00至2.70)。最佳矫正视力中位数有显著改善(p = 0.005)。没有术后低眼压和眼内炎的病例。其他并发症也很少,如1只眼前房硅油、3只眼视网膜前膜和2只眼黄斑裂孔。

结论

微创玻璃体切割术是治疗孔源性视网膜脱离的一种有效的初始手术方法,具有良好的解剖和视觉效果,并发症最少。

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