Girard P, Navarro F, Boscher C, Mercier P
J Fr Ophtalmol. 1985;8(10):613-8.
20 eyes have been treated for a retinal detachment due to a posterior pole break. Three successive, different operative techniques were used: macular silastic sponge, vitrectomy plus internal tamponade by silicone oil, vitrectomy plus internal tamponade by air or by a mixture of air 60% and SF6 40%. Macular sponges obtained a good rate of retinal reattachment (83.3%) but fonctionnal results are poor (no measurable visual acuity in the macular break cases). Vitrectomy plus silicone oil does not yield better anatomical results than sponges (66.6% succes rate) but the visual function is better preserved (2 measureable visual acuities on 3 macular break cases). Vitrectomy plus gas gave us the best anatomical (100% success rate) and functional results (4 measurable usual acuities on 6 macular break cases). Retinopexy is not necessary when the vitrectomy-gas technique is used. On the contrary, retinopexy is recommended when the vitrectomy-silicone technique is used in order to remove the silicone oil as safely as possible: this causes a dilemma in the case of a macular break. We think at the present time that vitrectomy-gas is the best way to treat these particular retinal detachments.
20只眼睛因后极部裂孔导致视网膜脱离而接受治疗。采用了三种连续不同的手术技术：黄斑部硅橡胶海绵、玻璃体切除术加硅油内填充、玻璃体切除术加空气或60%空气与40%六氟化硫混合气体内填充。黄斑部海绵取得了较好的视网膜复位率（83.3%），但功能结果较差（黄斑裂孔病例中无可测量的视力）。玻璃体切除术加硅油在解剖学结果上并不比海绵更好（成功率66.6%），但视觉功能得到了更好的保留（3例黄斑裂孔病例中有2例可测量视力）。玻璃体切除术加气体给我们带来了最佳的解剖学（100%成功率）和功能结果（6例黄斑裂孔病例中有4例可测量到正常视力）。使用玻璃体切除术 - 气体技术时无需视网膜固定术。相反，使用玻璃体切除术 - 硅油技术时建议进行视网膜固定术，以便尽可能安全地取出硅油：在黄斑裂孔的情况下这会造成两难局面。我们目前认为玻璃体切除术 - 气体是治疗这些特殊视网膜脱离的最佳方法。
