Pencak Martin, Stranak Zbynek, Dite Jakub, Vranova Jana, Studeny Pavel, Veith Miroslav
Department of Ophthalmology, Third Faculty of Medicine, Charles University, and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
Department of Medical Biophysics and Medical Informatics, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
PeerJ. 2025 Aug 11;13:e19795. doi: 10.7717/peerj.19795. eCollection 2025.
Rhegmatogenous retinal detachment (RRD) is a vision-threatening condition that requires prompt surgical intervention. With advancements in surgical techniques and equipment, pars plana vitrectomy (PPV) has become increasingly popular for the management of RRD. This, in turn, requires beginner vitreoretinal surgeons to be able to manage RRD early in their training.
Comparison of the results and complication rates of a 25-gauge (25 g) PPV with gas tamponade for RRD between experienced and inexperienced surgeons.
This is a retrospective comparative consecutive case series study of patients with uncomplicated RRD treated with 25 g PPV with gas tamponade. Patients were divided into two groups: in the experienced surgeon group (ESG), the procedure was performed by an experienced vitreoretinal surgeon, in the inexperienced surgeon group (ISG), it was performed by two inexperienced surgeons. Anatomical and functional results and complication rates were compared between the two groups.
A total of 216 eyes were included in the study. In the ESG (106 eyes), the single operation success rate was 94.3%, and the final success rate was 100%. In the ISG (110 eyes), the single operation success rate was 93.6%, and the final success rate was 100%. The difference in single surgery success rate between groups was not statistically significant ( = 0.828). The mean postoperative BCVA improvement was 0.348 decimal in the ESG and 0.405 decimal in the ISG ( = 0.234). The difference in complication rates between groups was not significant.
A 25 g PPV with gas tamponade for the treatment of RRD yields excellent anatomical results and improvement in best-corrected visual acuity (BCVA). With good technique and the use of modern vitrectomy machines and instruments, some inexperienced surgeons can achieve a high single-surgery success rate, suggesting a short learning curve. The complication rate is comparable between experienced and inexperienced surgeons.
孔源性视网膜脱离（RRD）是一种威胁视力的疾病，需要及时进行手术干预。随着手术技术和设备的进步，玻璃体切除术（PPV）在RRD的治疗中越来越受欢迎。这反过来要求玻璃体视网膜外科新手在培训早期就能处理RRD。
比较经验丰富和经验不足的外科医生使用25G PPV联合气体填塞治疗RRD的结果和并发症发生率。
这是一项回顾性比较连续病例系列研究，纳入接受25G PPV联合气体填塞治疗的单纯性RRD患者。患者分为两组：经验丰富的外科医生组（ESG），手术由经验丰富的玻璃体视网膜外科医生进行；经验不足的外科医生组（ISG），手术由两名经验不足的外科医生进行。比较两组的解剖和功能结果以及并发症发生率。
本研究共纳入216只眼。ESG组（106只眼）单次手术成功率为94.3%，最终成功率为100%。ISG组（110只眼）单次手术成功率为93.6%，最终成功率为100%。两组单次手术成功率的差异无统计学意义（P = 0.828）。ESG组术后平均最佳矫正视力（BCVA）提高0.348 logMAR，ISG组为0.405 logMAR（P = 0.234）。两组并发症发生率的差异无统计学意义。
25G PPV联合气体填塞治疗RRD可获得良好的解剖结果，并改善最佳矫正视力（BCVA）。凭借良好的技术以及现代玻璃体切除设备和器械的使用，一些经验不足的外科医生可获得较高的单次手术成功率，提示学习曲线较短。经验丰富和经验不足的外科医生的并发症发生率相当。
