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无定位及冷冻疗法的简化节段性巩膜扣带术:与传统节段性巩膜扣带术的回顾性比较

Simplified segmental scleral buckling without localization and cryopexy: A retrospective comparison with conventional segmental scleral buckling.

作者信息

Lin Pei-Hsuan, Lee Yi-An, Wang Lu-Chun

机构信息

Department of Ophthalmology, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan.

出版信息

Taiwan J Ophthalmol. 2024 Jan 19;14(4):588-593. doi: 10.4103/tjo.TJO-D-23-00093. eCollection 2024 Oct-Dec.

Abstract

PURPOSE

The aim of this study was to propose a simplified segmental scleral buckling (SSSB) technique that does not require break localization for less-experienced vitreoretinal surgeons.

MATERIALS AND METHODS

This retrospective study compared the clinical results of 46 conventional and 23 SSSB (conventional segmental SB [CSSB] and SSSB, respectively) procedures in a tertiary referral retinal center in Taiwan between 2008 and 2019. In the CSSB group, breaks were localized during surgery. In the SSSB group, a wider sponge band and a longer scleral buckle were used to maximize the chances of sealing the retinal breaks based on the preoperative fundus examination findings and to minimize the positioning error caused by cyclotorsion, without performing indirect ophthalmoscopy. The primary outcome was assessed after 6 months. Patient characteristics, surgical parameters, and outcomes were compared between groups. The main outcomes were the duration of surgery, changes in visual acuity, primary success rate, rhegmatogenous retinal detachment recurrence rate, and the frequency of further laser photocoagulation.

RESULTS

SSSB had a shorter duration than CSSB and was associated with more frequent use of longer and wider explants and need for further laser retinopexy. Both groups showed high primary success rates (95.65%).

CONCLUSION

The primary success rates for the SSSB and CSSB groups were comparable and equally high. SSSB required laser retinopexy more frequently and was a shorter procedure.

摘要

目的

本研究的目的是提出一种简化的节段性巩膜扣带术(SSSB)技术,该技术不需要对经验较少的玻璃体视网膜外科医生进行裂孔定位。

材料与方法

这项回顾性研究比较了2008年至2019年台湾一家三级转诊视网膜中心46例传统节段性巩膜扣带术(CSSB)和23例SSSB手术的临床结果。在CSSB组中,手术期间进行裂孔定位。在SSSB组中,根据术前眼底检查结果,使用更宽的海绵带和更长的巩膜扣带,以最大限度地封闭视网膜裂孔,并将由眼球旋转引起的定位误差降至最低,而无需进行间接检眼镜检查。6个月后评估主要结局。比较两组患者的特征、手术参数和结局。主要结局包括手术时间、视力变化、一次成功率、孔源性视网膜脱离复发率以及进一步激光光凝的频率。

结果

SSSB的手术时间比CSSB短,并且与更频繁地使用更长更宽的植入物以及需要进一步的激光视网膜光凝有关。两组的一次成功率均很高(95.65%)。

结论

SSSB组和CSSB组的一次成功率相当且同样高。SSSB更频繁地需要激光视网膜光凝,并且手术时间更短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3c2/11717345/7938a55bd56a/TJO-14-588-g001.jpg

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