Takeuchi Jun, Koto Takashi, Inoue Makoto
Kyorin Eye Center, School of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Jpn J Ophthalmol. 2025 Sep 8. doi: 10.1007/s10384-025-01278-0.
To evaluate the clinical outcomes of pneumatic retinopexy (PnR) for a recurrent rhegmatogenous retinal detachment (RRD) due to superior retinal breaks following initial vitrectomy for a RRD.
Clinical investigations.
A retrospective study of 82 eyes of 82 patients who underwent vitrectomy by a single surgeon between November 2021 and March 2023. PnR was performed on 4 (4.9%) of 11 eyes that developed a recurrent RD. The PnR procedure involved injecting sulfur hexafluoride gas into the vitreous cavity while the patient was in the lateral or in the supine position. The patient was placed in the prone position after the injection, and then laser photocoagulation was performed.
A retinal reattachment was achieved in all four eyes that underwent rescue PnR. The gas infusion volume during the PnR was 4.3 to 5.6 ml for cases in which PnR was performed in the lateral position and 1.0 ml for a case in the supine position. The duration of the gas tamponade was 15 to 21 days for patients who had PnR in the lateral position and 11 days for patients who had PnR in the supine position. The best-corrected visual acuity after the treatment improved in all patients. No serious complications were associated with the PnR.
The results indicate that rescue PnR may be an effective treatment for a recurrent RRD due to superior retinal breaks after vitrectomy for a RRD to achieve retinal reattachment without reoperation or hospitalization.
评估在首次玻璃体切除术后因上方视网膜裂孔导致复发性孔源性视网膜脱离(RRD)行气体视网膜固定术(PnR)的临床效果。
临床研究。
回顾性研究2021年11月至2023年3月间由同一位外科医生为82例患者实施玻璃体切除术的82只眼。在11只发生复发性视网膜脱离的眼中,4只眼(4.9%)接受了PnR治疗。PnR手术是在患者处于侧卧位或仰卧位时向玻璃体腔注入六氟化硫气体。注射后患者改为俯卧位,然后进行激光光凝。
接受挽救性PnR治疗的4只眼均实现了视网膜复位。侧卧位行PnR治疗的病例,气体注入量为4.3至5.6毫升,仰卧位行PnR治疗的1例注入量为1.0毫升。侧卧位行PnR治疗的患者气体填塞持续时间为15至21天,仰卧位行PnR治疗的患者为11天。所有患者治疗后的最佳矫正视力均有提高。PnR治疗未出现严重并发症。
结果表明,挽救性PnR可能是一种有效的治疗方法,用于玻璃体切除术后因上方视网膜裂孔导致的复发性RRD,可在无需再次手术或住院的情况下实现视网膜复位。