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巨大孔源性视网膜脱离伴视网膜裂孔的特征和手术结果。

Characteristics and surgical outcomes of giant retinal tear associated rhegmatogenous retinal detachment.

机构信息

Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand.

出版信息

Sci Rep. 2024 Aug 27;14(1):19943. doi: 10.1038/s41598-024-70898-2.

Abstract

Giant retinal tear-associated rhegmatogenous retinal detachment (GRT-RRD) presents a significant surgical challenge. Trauma stands out as one of the risk factors. This retrospective case series aims to assess the outcomes of GRT-RRD patients treated with pars plana vitrectomy (PPV), distinguishing between non-trauma and blunt ocular trauma cases. The medical records and relevant retinal imaging of 60 GRT-RRD patients undergoing PPV and followed with a mean (SD) of 21.2 (13.4) months were reviewed (47 were non-trauma-related and 13 were trauma-related). Both the non-trauma and trauma groups exhibited comparable distribution of proliferative vitreoretinopathy grade (P = 0.067). Following the primary operation, there was no statistically significant difference in the proportion of patients achieving single surgery anatomical success between the non-trauma group (27/47 patients, 57.5%) and the trauma-related group (9/13 patients, 69.2%) (P = 0.534). At the final follow-up, 17 patients remained tamponade with silicone oil. Among the remaining 43 patients, 33/34 patients (97.1%) in the non-trauma group and 9/9 patients (100%) in the non-trauma group (P = 0.661) achieved comparable final surgical anatomical success. Additionally the final vision was comparable between the two trauma categories (Snellen equivalent of 20/125 for the non-trauma group and 20/200 for the trauma group, P = 0.331). In multivariable regression, no significant factors related to primary reattachment rate or final vision were identified. Non-penetrating ocular trauma did not emerge as a significant risk factor for recurrent detachment post-surgery. This study supports that PPV outcomes in GRT-RRD patients are unaffected by the ocular trauma association and reports the effectiveness of PPV in managing these patients.

摘要

巨大裂孔性视网膜脱离相关的孔源性视网膜脱离(GRT-RRD)是一项重大的手术挑战。创伤是一个重要的危险因素。本回顾性病例系列旨在评估接受玻璃体切除术(PPV)治疗的 GRT-RRD 患者的结果,将其分为非创伤性和钝性眼外伤病例。回顾了 60 例接受 PPV 治疗并平均(标准差)随访 21.2(13.4)个月的 GRT-RRD 患者的病历和相关视网膜图像(47 例与非创伤无关,13 例与创伤有关)。非创伤组和创伤组的增殖性玻璃体视网膜病变(PVR)分级分布相似(P=0.067)。初次手术后,非创伤组(27/47 例,57.5%)和创伤相关组(9/13 例,69.2%)患者单次手术解剖成功率的比例无统计学差异(P=0.534)。最终随访时,17 例患者仍用硅油填塞。在其余 43 例患者中,非创伤组 33/34 例(97.1%)和非创伤组 9/9 例(100%)(P=0.661)最终获得了相似的手术解剖成功。此外,两组的最终视力相当(非创伤组为 Snellen 等效视力 20/125,创伤组为 20/200,P=0.331)。多变量回归分析未发现与初次再附着率或最终视力相关的显著因素。非穿透性眼外伤并不是手术后复发性脱离的显著危险因素。本研究支持 PPV 治疗 GRT-RRD 患者的结果不受眼外伤的影响,并报告了 PPV 治疗这些患者的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30e/11358328/329a3e4e4ec5/41598_2024_70898_Fig1_HTML.jpg

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