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巩膜扣带术联合睫状光凝术-接触式与非接触式广角观察系统(CAB-CNV):一项回顾性、多中心临床研究。

Chandelier-assisted scleral buckle surgery - contact versus non-contact wide-angle viewing system (CAB-CNV): A retrospective, multicenter, clinical study.

机构信息

Department of Vitreoretinal Services, National Institute of Ophthalmology, Pune, India.

Department of Vitreoretinal Services, Retina Foundation, Ahmedabad, India.

出版信息

Indian J Ophthalmol. 2024 Jul 1;72(7):1043-1048. doi: 10.4103/IJO.IJO_2820_23. Epub 2024 Mar 8.

DOI:10.4103/IJO.IJO_2820_23
PMID:38454850
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11329811/
Abstract

PURPOSE

To investigate and compare the anatomic and functional outcomes of chandelier-assisted scleral buckling (CASB) surgery using contact versus non-contact lens-based wide-angle viewing systems (WAVSs) in rhegmatogenous retinal detachment (RRD) patients.

METHODS

This was a retrospective, multicenter study evaluating the anatomic (reattachment rate) and visual acuity (VA) outcomes at 6 months post-CASB for primary RRD.

RESULTS

Forty-seven RRD patients underwent CASB with a non-contact WAVS (Group C1) and 90 with a contact lens WAVS (Group C2). Preoperative parameters including myopia, macula-off RRD, posterior vitreous detachment, number of retinal breaks, and retinal dialysis as the etiology of RRD did not differ significantly between the two groups. The outcomes of retinal attachment (85.11% of C1 patients and 76.67% of C2 patients, P = 0.34) and final visual outcome (VA ≥6/12: C1 = 61.7%; C2 = 46.67%, P = 0.13) were also comparable. Furthermore, no significant difference in postoperative complications such as cataracts, glaucoma, infection, buckle exposure, and buckle failure was observed. Finally, both groups were comparable in terms of re-detachment rates (10.64% in C1 and 23.33% in C2, P = 0.11).

CONCLUSION

The two WAVS approaches used in CASB surgery have comparable surgical and functional outcomes and postoperative complications. The operating surgeon can freely choose between these viewing platforms during the contemporary scleral bucking (SB) surgery without impacting the outcome.

摘要

目的

研究和比较应用接触式和非接触式广角镜观察系统(WAVS)行睫状环扎辅助巩膜扣带术(CASB)治疗孔源性视网膜脱离(RRD)患者的解剖和功能结果。

方法

这是一项回顾性多中心研究,评估原发性 RRD 患者行 CASB 术后 6 个月的解剖(再附率)和视力(VA)结果。

结果

47 例 RRD 患者行非接触式 WAVS 下的 CASB(C1 组),90 例行接触镜 WAVS 下的 CASB(C2 组)。两组患者术前参数包括近视、黄斑脱离型 RRD、后玻璃体脱离、视网膜裂孔数量和视网膜裂孔性脱离的病因等均无显著差异。视网膜复位(C1 组为 85.11%,C2 组为 76.67%,P=0.34)和最终视力结果(VA≥6/12:C1 组为 61.7%;C2 组为 46.67%,P=0.13)也相似。此外,两组术后并发症如白内障、青光眼、感染、巩膜扣带外露和失败等也无显著差异。最后,两组再脱离率(C1 组为 10.64%,C2 组为 23.33%,P=0.11)也相似。

结论

在 CASB 手术中应用这两种 WAVS 方法具有相似的手术和功能结果及术后并发症。在当代巩膜扣带术(SB)中,手术医生可以自由选择这些观察平台,而不会影响手术结果。

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本文引用的文献

1
CHANDELIER-ASSISTED VERSUS STANDARD SCLERAL BUCKLING FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT: A Randomized Clinical Study.睫状体平坦部巩膜扣带术与标准巩膜扣带术治疗原发性孔源性视网膜脱离的随机临床研究。
Retina. 2022 Sep 1;42(9):1745-1755. doi: 10.1097/IAE.0000000000003519.
2
Outcome of Non-drainage Scleral Buckling in Primary Rhegmatogenous Retinal Detachment.原发性孔源性视网膜脱离巩膜扣带术不引流的结果。
Nepal J Ophthalmol. 2021 Jan;13(25):65-72. doi: 10.3126/nepjoph.v12i2.31833.
3
Modified Encircling Scleral Buckle Technique Without Subretinal Fluid Drainage or Retinopexy.改良式无视网膜下液引流或视网膜固定术的环扎巩膜扣带技术
Ophthalmol Ther. 2020 Sep;9(3):641-651. doi: 10.1007/s40123-020-00279-1. Epub 2020 Jul 14.
4
Non-contact wide-angled visualization with chandelier-assisted scleral buckling for primary uncomplicated rhegmatogenous retinal detachment.应用钟摆式巩膜扣带术的非接触广角可视化技术治疗原发性单纯孔源性视网膜脱离。
Graefes Arch Clin Exp Ophthalmol. 2020 Sep;258(9):1857-1861. doi: 10.1007/s00417-020-04737-1. Epub 2020 May 14.
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Impact of contact versus non-contact wide-angle viewing systems on outcomes of primary retinal detachment repair (PRO study report number 5).接触式与非接触式广角观察系统对原发性视网膜脱离修复结果的影响(PRO 研究报告第 5 号)。
Br J Ophthalmol. 2021 Mar;105(3):410-413. doi: 10.1136/bjophthalmol-2020-315948. Epub 2020 May 14.
6
Real-life comparison of the viewing angle and the image quality of two commonly used viewing systems for vitreoretinal surgery.两种常用玻璃体视网膜手术用观察系统的视角和成像质量的真实生活比较。
Turk J Med Sci. 2020 Jun 23;50(4):689-696. doi: 10.3906/sag-1910-11.
7
Updated chandelier illumination-assisted scleral buckling using 3D visualization system.使用3D可视化系统的更新后的吊灯照明辅助巩膜扣带术。
Clin Ophthalmol. 2019 Sep 6;13:1743-1748. doi: 10.2147/OPTH.S218975. eCollection 2019.
8
Chandelier-assisted scleral buckling using wide angle viewing contact lens for pseudophakic retinal detachment repair.使用广角观察接触镜辅助吊灯式巩膜扣带术治疗人工晶状体眼视网膜脱离
Int J Ophthalmol. 2019 Apr 18;12(4):627-633. doi: 10.18240/ijo.2019.04.17. eCollection 2019.
9
Scleral Buckling under a Slit-lamp Illumination System with a Contact Wide-angle Viewing Lens Compared with an Indirect Ophthalmoscope.与间接检眼镜相比,在带有接触式广角观察透镜的裂隙灯照明系统下进行巩膜扣带术。
Korean J Ophthalmol. 2018 Apr;32(2):126-133. doi: 10.3341/kjo.2017.0092. Epub 2018 Mar 13.
10
Comparison of scleral buckling using wide-angle viewing systems and indirect ophthalmoscope for rhegmatogenous retinal detachment.广角观察系统与间接检眼镜用于孔源性视网膜脱离巩膜扣带术的比较
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