Department of Ophthalmology, University of Kansas School of Medicine, 7400 State Line Road, Prairie Village, 66208, Kansas City, KS, USA.
BMC Ophthalmol. 2023 Sep 14;23(1):376. doi: 10.1186/s12886-023-03120-y.
Proliferative vitreoretinopathy (PVR) is the leading cause of recurrent retinal detachment. Anterior PVR can contribute to recurrent retinal detachment and is often difficult to remove during conventional pars plana vitrectomy. The purpose of this study is to report surgical outcomes of single endoscopy-assisted pars plana vitrectomy (E-PPV) in patients with tractional retinal detachments associated with anterior proliferative vitreoretinopathy and epiciliary membranes.
Retrospective review of E-PPV between 2017 and 2021 at a tertiary referral center. Inclusion criteria involved adult patients who underwent E-PPV for tractional retinal detachment with anterior PVR and epiciliary membranes. Data collection included patients' demographics, ophthalmic exam findings, and surgical outcomes. A series of independent sample tests of proportion were conducted using a p-value of 0.05 as the threshold for statistical significance.
Eighteen out of 55 patients who underwent E-PPV met the inclusion criteria. There were six females (33%) and 12 males (p-value = 0.096). Age ranged between 27 and 82 years old (mean age 52.1 ± 17.3 years). Nine patients (50%) had a history of ipsilateral retinal detachment repair. Single E-PPV success rate was 100% after three months, and 94.4% at the latest follow up visit. Recurrent retinal detachment with posterior PVR occurred in one patient four months after surgery. Cataract progressed in 57% (8/14) of phakic patients, with 63% (5/8) undergoing cataract extraction surgery within the first postoperative year.
E-PPV enabled epiciliary membrane and anterior PVR visualization and removal. The single E-PPV success rate remained high at the latest follow up visit. E-PPV enabled the preservation of the phakic lens in all study patients. Larger prospective studies are needed on the role of E-PPV in retina surgeries.
增生性玻璃体视网膜病变（PVR）是视网膜脱离复发的主要原因。前 PVR 可导致视网膜脱离复发，并且在常规经睫状体平坦部玻璃体切除术（PPV）中通常难以清除。本研究旨在报告单内镜辅助经睫状体平坦部玻璃体切除术（E-PPV）治疗伴有前增生性玻璃体视网膜病变和睫状膜的牵拉性视网膜脱离患者的手术结果。
回顾性分析 2017 年至 2021 年在一家三级转诊中心接受 E-PPV 的患者。纳入标准包括接受 E-PPV 治疗伴有前 PVR 和睫状膜的牵拉性视网膜脱离的成年患者。数据收集包括患者的人口统计学资料、眼科检查结果和手术结果。采用双侧检验，以 p 值为 0.05 作为统计学显著性的阈值，进行一系列独立样本比例检验。
在 55 例接受 E-PPV 的患者中，有 18 例符合纳入标准。其中女性 6 例（33%），男性 12 例（p 值=0.096）。年龄在 27 至 82 岁之间（平均年龄 52.1±17.3 岁）。9 例（50%）患者有同侧视网膜脱离修复史。术后 3 个月单 E-PPV 成功率为 100%，末次随访时为 94.4%。1 例患者术后 4 个月发生后发性 PVR 视网膜脱离。57%（8/14）的有晶状体眼患者发生白内障进展，其中 63%（5/8）在术后 1 年内行白内障摘除术。
E-PPV 可使睫状膜和前 PVR 可视化并清除。末次随访时，单 E-PPV 成功率仍较高。E-PPV 使所有研究患者的晶状体得以保留。需要更大规模的前瞻性研究来探讨 E-PPV 在视网膜手术中的作用。
