Bernardi Enrico, Ferro Desideri Lorenzo, Artemiev Dmitri, Zinkernagel Martin, Anguita Rodrigo
Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Bern Photographic Reading Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
BMJ Open Ophthalmol. 2024 Dec 4;9(1):e001812. doi: 10.1136/bmjophth-2024-001812.
To compare the anatomical and functional outcomes of pars plana vitrectomy (PPV) alone versus PPV with the addition of a scleral buckle in treating inferior rhegmatogenous retinal detachments (RRDs).
Comparative, retrospective cohort study including patients who were diagnosed with primary inferior RRD, defined as RRD with one or more retinal tears located between 4 and 8 hours, and divided into two treatment groups. Group 1 patients were treated with PPV and gas tamponade alone, whereas group 2 patients were treated with PPV, gas tamponade and the addition of an encirclement band. Demographic and clinical features were collected, and surgical outcomes of both groups were analysed. A univariable logistic regression model evaluated the factors influencing surgical success.
A total of 161 eyes were included in the study. The average age at diagnosis was 64.1 years. There was a male predominance (66.5%), and most patients had macula-off detachments (54%). Group 1 included 75 eyes (43.1%), whereas group 2 included 86 eyes (56.9%). Baseline best-corrected visual acuity was 1.00 logMAR, improving to 0.62 logMAR at the last visit (p=0.003). No significant difference in primary success rate was observed between the two groups (86.0% with encirclement band vs 80.0% without; p=0.3). The mean follow-up period was 29 weeks (SD 39).
PPV alone may be as effective as PPV with an encirclement band when treating inferior RRDs. The choice of tamponade does not appear to significantly influence anatomical success, and short-acting gas can be considered sufficient for favourable outcomes.
比较单纯玻璃体切割术（PPV）与联合巩膜环扎术的PPV治疗下方孔源性视网膜脱离（RRD）的解剖学和功能结局。
一项比较性回顾性队列研究，纳入被诊断为原发性下方RRD的患者，原发性下方RRD定义为视网膜裂孔位于4至8点钟之间的RRD，并分为两个治疗组。第1组患者仅接受PPV和气体填充治疗，而第2组患者接受PPV、气体填充并加用环扎带治疗。收集人口统计学和临床特征，并分析两组的手术结局。采用单变量逻辑回归模型评估影响手术成功的因素。
本研究共纳入161只眼。诊断时的平均年龄为64.1岁。男性占优势（66.5%），大多数患者为黄斑脱离（54%）。第1组包括75只眼（43.1%），而第2组包括86只眼（56.9%）。基线最佳矫正视力为1.00 logMAR，末次随访时提高至0.62 logMAR（p = 0.003）。两组之间的初次成功率无显著差异（联合环扎带组为86.0%，未联合组为80.0%；p = 0.3）。平均随访期为29周（标准差39）。
在治疗下方RRD时，单纯PPV可能与联合环扎带的PPV效果相同。填充方式的选择似乎对解剖学成功无显著影响，短效气体可被认为足以获得良好结局。
