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短期全氟碳液体填塞玻璃体切除术治疗伴有下方视网膜裂孔和增殖性玻璃体视网膜病变的视网膜脱离

Vitrectomy With Short-Term Perfluorocarbon Liquid Tamponade for Retinal Detachment With Inferior Retinal Breaks and Proliferative Vitreoretinopathy.

作者信息

Citirik Mehmet, Ilhan Cagri, Horozoglu Ceran Tugce, Teke Mehmet Yasin

机构信息

Department of Ophthalmology, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Turkey.

Department of Ophthalmology, Dunya Goz Hospital, Ankara, Turkey.

出版信息

J Vitreoretin Dis. 2024 Dec 7:24741264241303714. doi: 10.1177/24741264241303714.

Abstract

To assess and compare the results of pars plana vitrectomy (PPV) with short-term perfluorocarbon liquid (PFCL) tamponade and combined PPV with scleral buckling to treat rhegmatogenous retinal detachment (RRD) with inferior retinal breaks complicated by proliferative vitreoretinopathy (PVR). The medical records of patients who had vitreoretinal surgery for RRD with inferior retinal breaks complicated by PVR were reviewed. Group 1 had PPV with PFCL, and Group 2 had PPV with scleral buckling. Silicone oil tamponade was used in all cases of PPV with scleral buckling. The anatomic and functional outcomes and duration of surgery were compared between the 2 groups. Group 1 comprised 48 eyes and Group 2, 36 eyes. No statistically significant differences were found in the demographic and baseline clinical characteristics between the groups ( > .05). The mean (±SD) duration of the initial surgery was 42.82 ± 15.25 minutes (range, 25-65) in Group 1 and 81.46 ± 37.48 minutes (range, 45-115) in Group 2. The difference was significant ( < .001). At the end of the follow-up period, recurrent RD occurred in 3 eyes (6.2%) in Group 1 and 2 eyes (5.5%) in Group 2, with no significant difference ( > .05). There was no significant difference between the groups in the mean best-corrected visual acuity or mean intraocular pressure at 6 months ( > .05). Seven eyes (14.5%) in Group 1 had anterior chamber cells and flares after the initial surgery. The inflammation resolved with topical steroid application. The results of PPV with PFCL are similar to those of PPV with scleral buckling for managing RRD with inferior retinal breaks complicated by PVR. Favorable anatomic and functional outcomes are maintained.

摘要

评估并比较采用短期全氟碳液体(PFCL)填塞的玻璃体切除术(PPV)与PPV联合巩膜扣带术治疗伴有增生性玻璃体视网膜病变(PVR)的下方视网膜裂孔性视网膜脱离(RRD)的效果。回顾性分析因伴有PVR的下方视网膜裂孔性RRD接受玻璃体视网膜手术患者的病历。第1组采用PPV联合PFCL,第2组采用PPV联合巩膜扣带术。所有PPV联合巩膜扣带术的病例均使用硅油填塞。比较两组的解剖和功能结局以及手术时长。第1组48眼,第2组36眼。两组间人口统计学和基线临床特征无统计学显著差异(P>0.05)。第1组初次手术的平均(±标准差)时长为42.82±15.25分钟(范围25 - 65分钟),第2组为81.46±37.48分钟(范围45 - 115分钟)。差异有统计学意义(P<0.001)。随访期末,第1组3眼(6.2%)发生复发性视网膜脱离,第2组2眼(5.5%)发生复发性视网膜脱离(P>0.05),差异无统计学意义。两组在6个月时的平均最佳矫正视力或平均眼压无显著差异(P>0.05)。第1组7眼(14.5%)在初次手术后出现前房细胞和闪光。局部应用类固醇后炎症消退。对于伴有PVR的下方视网膜裂孔性RRD,采用PFCL的PPV效果与PPV联合巩膜扣带术相似。可维持良好的解剖和功能结局。

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