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采用 25G 经睫状体平坦部玻璃体切割术联合空气填充治疗下方裂孔性孔源性视网膜脱离(PVR≤C2)的疗效观察。

The efficacious combined treatment of rhegmatogenous retinal detachment (PVR ≤ C2) with inferior breaks using 25-gauge pars plana vitrectomy and air tamponade.

机构信息

Department of Ophthalmology, Liuzhou Red Cross Hospital, Eye Hospital of Liuzhou City, Liuzhou, Guangxi, China.

出版信息

Medicine (Baltimore). 2024 Sep 27;103(39):e39555. doi: 10.1097/MD.0000000000039555.

Abstract

To examine the surgical results of 25-gauge (25-G) pars plana vitrectomy (PPV) with air tamponade for the repair of primary rhegmatogenous retinal detachment (RRD) with inferior retinal breaks. A retrospective consecutive study was conducted from March 2019 to February 2023 on 27 patients with primary RRD with inferior breaks who underwent 25-G PPV with air tamponade. Once the surgery was completed, the patients were monitored for a minimum of 6 months. Postoperative best-corrected visual acuity (BCVA), postoperative complications, and the rate of single surgery anatomical success were the primary outcome measures. The average age of the 12 female and 15 male study participants was 50.2 ± 12.8 years. The follow-up period was 10.3 ± 3.9 months on average. On average, the affected clock hours were 5.6 ± 2.1 hours, and the average number of retinal breaks was 2.2 ± 1.8. Moreover, the final anatomical success rate was 100%, compared to the estimated initial anatomical success rate of 96.30% following a single surgery. At 6 months, we also noticed a significant change in the mean BCVA, which went from 1.62 ± 0.71 logMAR (preoperative) to 0.89 ± 0.61 logMAR (postoperative) (P < .001). On the first day and the week following surgery, the mean intraocular pressure (IOP) was similar (all P > .05). One patient experienced postoperative complications such as retinal redetachment, which was addressed with the same procedure. After surgery, 2 patients had IOP of 35 and 28 mm Hg for 1 week. Two weeks following surgery, their IOP essentially returned to normal after receiving antihypertensive medication. No other notable postoperative complications were observed. According to this research, 25-G PPV with air tamponade has a satisfactory success rate in repairing primary RRD with inferior breaks. This procedure also produces quicker visual recovery and is linked to fewer complications.

摘要

探讨 25G 经睫状体平坦部玻璃体切割术(PPV)联合空气填充治疗下方裂孔性原发性孔源性视网膜脱离(RRD)的手术效果。对 2019 年 3 月至 2023 年 2 月期间收治的 27 例下方裂孔性原发性 RRD 患者行 25G PPV 联合空气填充术进行回顾性连续研究。所有患者术后均随访至少 6 个月。主要观察指标为术后最佳矫正视力(BCVA)、术后并发症及单次手术解剖复位成功率。12 例女性和 15 例男性患者平均年龄为 50.2±12.8 岁。平均随访时间为 10.3±3.9 个月。平均患眼受累时钟小时数为 5.6±2.1 小时,平均裂孔数为 2.2±1.8 个。此外,最终解剖复位成功率为 100%,而单次手术估计的初始解剖复位成功率为 96.30%。术后 6 个月,我们还注意到平均 BCVA 显著改善,从术前的 1.62±0.71 logMAR 改善至术后的 0.89±0.61 logMAR(P<0.001)。术后第 1 天和第 1 周,平均眼压(IOP)相似(均 P>0.05)。1 例患者发生术后视网膜脱离再脱离,经相同手术处理。术后 2 例患者 IOP 分别为 35 和 28mmHg 持续 1 周,2 周后接受降压药物治疗后 IOP 基本恢复正常。未观察到其他明显的术后并发症。本研究表明,25G PPV 联合空气填充治疗下方裂孔性原发性 RRD 成功率较高,视力恢复更快,并发症更少。

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Rhegmatogenous retinal detachment surgery: A review.孔源性视网膜脱离手术:综述。
Clin Exp Ophthalmol. 2023 Apr;51(3):271-279. doi: 10.1111/ceo.14205. Epub 2023 Jan 25.

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