Medicine Faculty, Department of Ophthalmology, Istanbul Medipol University, TEM Göztepe Cıkısı No:1 Bagcilar, 34214, Istanbul, Turkey.
Department of Ophthalmology, The Princess Alexandra Hospital NHS Trust, London, UK.
Graefes Arch Clin Exp Ophthalmol. 2024 Oct;262(10):3109-3116. doi: 10.1007/s00417-024-06466-1. Epub 2024 Apr 17.
To report the results of invivo generated autologous plasmin enzyme(IVAP) assisted vitrectomy, partial circumferential-oral retinotomy and silicone oil injection for surgical treatment of patients with chronic retinal detachment without posterior vitreous detachment(PVD).
Study was performed in retrospective, comparative manner. A total of 16 consecutive eyes with chronic retinal detachment who had intravitreal injection of 50 µgr of t-PA and 0.1 ml of autologous whole blood, 3 days before surgery, underwent lens extraction with phacoemulsification, IVAP assisted vitrectomy, partial circumferential-oral retinotomy, and silicone oil injection(Study Group) were compared to a similar group of 15 eyes who had undergone vitrectomy, with or without lens extraction and silicone oil injection(Control Group) for the treatment of chronic retinal detachment. Primary outcome measures were initial retinal reattachment and number of operations at postoperative 6 months.
Mean age of 16 patients of whom 7 were female, was 39.31 ± 17.76 years in study group and 15 patients of whom 4 were female, was 35.40 ± 11.92 years (p = 0.607). Mean follow-up time was 10.68 ± 7.15 months in study group and 29.13 ± 18.83 months in control group (p = 0.001). Initial retinal reattachment was achieved in 87.50% (14 out of 16 patients) in the study group, whereas it was 46.66% (7 out of 15 patients) in the control group (p = 0.017). The mean number of operations for reattachment in the study group was 1.12 ± 0.34, whereas it was 1.46 ± 0.51 in the control group (p = 0.039) at postoperative 6 months While the preoperative LogMAR visual acuity was 1.25 ± 0.64, it was 0.53 ± 0.37 at postoperative 6 months in study group (p = 0.001). Conversely, in the control group, the preoperative LogMAR visual acuity was 1.22 ± 0.33, it was 1.20 ± 0.89 at postoperative 6 months (p = 0.780). At postoperative 6 months,, epiretinal membrane developed in 2 eyes of the study group, 1 eye in the control group, and phthisis bulbi occurred in 1 eye of control group.
IVAP assisted vitrectomy, partial circumferential-oral retinotomy and silicone oil injection is effective and safe for the surgical treatment of chronic retinal detachment without PVD.
报告体内生成的自体纤溶酶（IVAP）辅助玻璃体切除术、部分环形口部视网膜切开术和硅油注射治疗无后玻璃体脱离（PVD）的慢性视网膜脱离患者的结果。
本研究为回顾性、对比性研究。共纳入 16 例连续慢性视网膜脱离患者，术前 3 天于玻璃体内注射 50μg t-PA 和 0.1ml 自体全血，行晶状体超声乳化摘除术，IVAP 辅助玻璃体切除术、部分环形口部视网膜切开术和硅油注射（研究组），与 15 例接受玻璃体切除术、联合或不联合晶状体超声乳化摘除术和硅油注射（对照组）治疗慢性视网膜脱离的患者进行比较。主要观察指标为术后 6 个月时的初始视网膜复位和手术次数。
研究组 16 例患者中，女性 7 例，平均年龄为 39.31±17.76 岁；对照组 15 例患者中，女性 4 例，平均年龄为 35.40±11.92 岁（p=0.607）。研究组平均随访时间为 10.68±7.15 个月，对照组为 29.13±18.83 个月（p=0.001）。研究组初始视网膜复位率为 87.50%（14/16 例），对照组为 46.66%（7/15 例）（p=0.017）。研究组术后 6 个月的平均再手术次数为 1.12±0.34 次，对照组为 1.46±0.51 次（p=0.039）。术后 6 个月时，研究组术前 LogMAR 视力为 1.25±0.64，术后为 0.53±0.37（p=0.001）。相反，对照组术前 LogMAR 视力为 1.22±0.33，术后为 1.20±0.89（p=0.780）。术后 6 个月时，研究组有 2 只眼发生视网膜内膜，对照组有 1 只眼发生视网膜内膜，对照组有 1 只眼发生眼球萎缩。
IVAP 辅助玻璃体切除术、部分环形口部视网膜切开术和硅油注射治疗无 PVD 的慢性视网膜脱离是有效且安全的。
