Farrahi Fereydoun, Kasiri Ali, Feghhi Mostafa, Asadi-Moghaddam Mahsa
Department of Ophthalmology, Faculty of Medicine, Infectious Ophthalmic Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Med Hypothesis Discov Innov Ophthalmol. 2022 Dec 3;11(3):104-109. doi: 10.51329/mehdiophthal1453. eCollection 2022 Fall.
Rhegmatogenous retinal detachment (RRD) is a separation of the neurosensory retina from the retinal pigment epithelium as a result of liquid vitreous passing through a retinal break. Scleral buckling surgery (SB) is a conventional treatment for RRD. In SB, a silicon explant is used to indent the sclera, reduce vitreous traction, and close the retinal break, and an encircling band is used circumferentially, leading to myopia. This study aimed to evaluate the functional and biometric outcomes after SB with absorbable band-tightening sutures in patients with pseudophakic RRD.
In this prospective interventional study, we included pseudophakic eyes with RRD treated surgically with SB and a temporary encircling band using a 6-0 absorbable Vicryl suture to tighten the band, instead of conventional permanent suture tightening. Anterior chamber depth (ACD), axial length (AL), intraocular pressure (IOP), spherical equivalent refractive error (SER), and best-corrected distance visual acuity (BCDVA) were measured preoperatively and at 1 day, 2 weeks, 3 months, and 6 months postoperatively.
We included 30 eyes of 30 patients with a mean (standard deviation [SD]) age of 66.1 (10.5) years who underwent SB with an absorbable band-tightening suture for pseudophakic RRD. Significant increases in AL and ACD were observed at 2 weeks after surgery, with a significant decline in values thereafter; however, at the 6-month follow-up, the values were significantly higher than those at baseline (all P < 0.05). Based on the Vicryl tension and its hydrolysis, mean (SD) SER at 2 weeks postoperatively was significantly more myopic than at baseline (-5.8 [1.6] D versus +1.3 [1.8] D). However, the mean (SD) SER decreased significantly throughout the 6-month follow-up (all P < 0.05), and it reached -1.8 (0.9) D, which was comparable with the mean baseline SER (P = 0.140). The participants experienced significant improvement in BCDVA throughout the follow-up period (all P < 0.05).
Using an absorbable suture to tighten the encircling band in patients with pseudophakic RRD can reduce postoperative myopia without adversely affecting the anatomical or functional outcomes. Future comparative studies with larger sample sizes and longer postoperative follow-up are needed to verify these findings.
孔源性视网膜脱离（RRD）是指神经感觉视网膜与视网膜色素上皮分离，这是由于液体玻璃体通过视网膜裂孔所致。巩膜扣带术（SB）是RRD的一种传统治疗方法。在巩膜扣带术中，使用硅质外植体压迫巩膜，减轻玻璃体牵引，并封闭视网膜裂孔，同时使用环形带环绕，会导致近视。本研究旨在评估在人工晶状体性RRD患者中使用可吸收带收紧缝线进行巩膜扣带术后的功能和生物测量结果。
在这项前瞻性干预研究中，我们纳入了接受巩膜扣带术及使用6-0可吸收薇乔缝线临时收紧环形带而非传统永久缝线收紧治疗的人工晶状体性RRD患者的患眼。术前及术后1天、2周、3个月和6个月测量前房深度（ACD）、眼轴长度（AL）、眼压（IOP）、等效球镜屈光不正（SER）和最佳矫正远视力（BCDVA）。
我们纳入了30例患者的30只眼，平均（标准差[SD]）年龄为66.1（10.5）岁，这些患者接受了用于人工晶状体性RRD的可吸收带收紧缝线的巩膜扣带术。术后2周观察到AL和ACD显著增加，此后数值显著下降；然而，在6个月随访时，这些数值显著高于基线水平（所有P<0.05）。基于薇乔缝线的张力及其水解情况，术后2周时平均（SD）SER显著比基线时更近视（-5.8[1.6]D对+1.3[1.8]D）。然而，在整个6个月随访期间，平均（SD）SER显著下降（所有P<0.05），并达到-1.8（0.9）D，与平均基线SER相当（P=0.140）。在整个随访期间，参与者的BCDVA有显著改善（所有P<0.05）。
在人工晶状体性RRD患者中使用可吸收缝线收紧环形带可减少术后近视，且不会对解剖或功能结果产生不利影响。需要未来进行更大样本量和更长术后随访时间的比较研究来验证这些发现。
