Mansour Ahmad M, López-Guajardo Lorenzo, Özdek Şengül, Popov Ivajlo, Parodi Battaglia Maurizio
Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.
Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon.
J Vitreoretin Dis. 2023 Dec 27;8(2):173-180. doi: 10.1177/24741264231220157. eCollection 2024 Mar-Apr.
To describe the visual outcomes and problems that resulted from surgical treatment of nanophthalmic complete retinal detachment (RD) with retina-lens contact. A multicenter retrospective case series with deep sclerectomy as a treatment was performed. Five cases had extensive deep sclerectomies, 3 with intended drainage of subretinal fluid (SRF). The RD resolved 1 week postoperatively in 4 cases and within 1 month in 1 case. The visual acuity improved from light perception to a median of 20/100. Three cases had longstanding lens touch beyond 1 year and improved VA to 20/100, 20/150, and hand motions, respectively. Complications included focal lens dialysis in 2 cases (passive drainage of SRF) and lens or intraocular lens dislocation in 1 case each (active drainage of SRF). Ultrasound biomicroscopy and anterior optical coherence tomography showed a very narrow angle and short zonules. Deep sclerectomy results in good anatomic and functional improvements in advanced cases of nanophthalmos exudative detachment, which is often considered to be incurable.
描述纳米小眼球完全性视网膜脱离(RD)采用视网膜-晶状体接触手术治疗后的视觉效果及问题。开展了一项以深层巩膜切除术作为治疗方法的多中心回顾性病例系列研究。5例接受了广泛的深层巩膜切除术,其中3例有意排出视网膜下液(SRF)。4例患者术后1周视网膜脱离得到解决,1例在1个月内解决。视力从光感提高到中位数为20/100。3例患者晶状体接触持续超过1年,视力分别提高到20/100、20/150和手动。并发症包括2例局限性晶状体悬韧带离断(SRF被动引流),1例晶状体或人工晶状体脱位(SRF主动引流)。超声生物显微镜检查和眼前段光学相干断层扫描显示房角极窄且悬韧带短。深层巩膜切除术可使晚期纳米小眼球渗出性脱离的解剖结构和功能得到良好改善,而这种情况通常被认为是无法治愈的。