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视网膜脱离因视网膜裂孔性脱离行巩膜扣带术——玻璃体视网膜专科医师的观点

Scleral buckling in retinal detachment due to retinal dialysis - A vitreoretina fellow's perspective.

作者信息

Balaji Akshaya, Verma Saurabh, Shaikh Nawazish, Azad Shorya V, Kumar Parmanand, Chawla Rohan, Kumar Vinod

机构信息

Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.

出版信息

Indian J Ophthalmol. 2025 Jan 1;73(Suppl 1):S164-S168. doi: 10.4103/IJO.IJO_813_24. Epub 2024 Oct 25.

Abstract

PURPOSE

To analyze the efficacy of scleral buckling in the hands of vitreo-retina (VR) fellows under training in eyes with retinal detachment associated with retinal dialysis and analyze the patient and retinal characteristics in these eyes.

METHODS

We carried out a retrospective consecutive case review at a tertiary eye care center in North India. Records of all the patients who had undergone scleral buckling (SB) for retinal dialysis-associated rhegmatogenous retinal detachment by VR fellows (with less than 2 years' experience) between January 2017 and January 2020 were reviewed.

RESULTS

Fifty-three eyes of 53 patients with a mean age of 20.77 years were analyzed. Of the patients, 73.58% were males. History of eye trauma was present in 71.69% patients. A total of 21 residents operated these 53 eyes. SB was able to achieve retinal attachment in a single surgery in 84.9% (45/53) eyes. Mean preoperative best corrected visual acuity was 1.9 ± 1.05 log of minimum angle of resolution (logMAR), which improved postoperatively to 1.07 ± 0.72 logMAR ( P < 0.001). Surgical success rate was 85.71% (24/28) in eyes with no proliferative vitreoretinopathy (PVR), 66.66% (2/3) in eyes with PVR-A, 91.66% (11/12) in eyes with PVR-B, and 80% (8/10) in eyes with PVR-C1. Fifty-two eyes had a single dialysis and one eye had two separate dialysis. Six eyes had giant retinal dialysis (dialysis greater than 3 clock hours) and all were due to trauma. Five patients had retinal dialysis in the fellow eye and were diagnosed with bilateral idiopathic retinal dialysis.

CONCLUSION

Scleral buckling is a safe and effective management for retinal dialysis retinal detachment even in the hands of VR fellows under training.

摘要

目的

分析玻璃体视网膜(VR)进修医师在处理伴有视网膜裂孔性视网膜脱离的视网膜透析眼中巩膜扣带术的疗效,并分析这些眼中的患者及视网膜特征。

方法

我们在印度北部的一家三级眼科护理中心进行了一项回顾性连续病例研究。回顾了2017年1月至2020年1月期间由VR进修医师(经验少于2年)对因视网膜透析相关孔源性视网膜脱离而接受巩膜扣带术(SB)的所有患者的记录。

结果

分析了53例患者的53只眼,平均年龄20.77岁。其中73.58%为男性。71.69%的患者有眼外伤史。共有21名住院医师为这53只眼实施了手术。SB在单次手术中使84.9%(45/53)的眼实现了视网膜复位。术前平均最佳矫正视力为1.9±1.05最小分辨角对数(logMAR),术后改善至1.07±0.72 logMAR(P<0.001)。在无增殖性玻璃体视网膜病变(PVR)的眼中手术成功率为85.71%(24/28),PVR-A级眼中为66.66%(2/3),PVR-B级眼中为91.66%(11/12),PVR-C1级眼中为80%(8/10)。52只眼有单个视网膜裂孔,1只眼有两个独立的视网膜裂孔。6只眼有巨大视网膜裂孔(裂孔大于3个钟点),均由外伤引起。5例患者在对侧眼有视网膜裂孔,被诊断为双侧特发性视网膜裂孔。

结论

即使是在接受培训的VR进修医师手中,巩膜扣带术对于视网膜透析性视网膜脱离也是一种安全有效的治疗方法。

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Scleral Buckling in the Treatment of Retinal Detachment Due to Retinal Dialysis.巩膜扣带术治疗视网膜脱离伴视网膜裂孔。
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