Girard P, Boscher C, Merad I, Forest A
J Fr Ophtalmol. 1983;6(12):975-9.
1148 patients underwent retinal detachment (RD) surgery between october 1st 1969 and december 31st 1979 with follow up assured until june 30th 1983 non idiopathic retinal detachments were excluded from this study which was focused on the risk factors concerning detachment of the second eye. With this time criteria the present rate of RD on the second eye is 4,03% : 39 eyes in 970 patients for whom the second eye was present examinable and free of any RD at the time of the first examination. A statistical analysis with the X2 test shows that male patients (p less than 0,025) and heavily myopic eyes (p less than 0,025) are at greater risk; giant tears (70 degrees and more) in the first eye are also an important risk factor. When it comes to preexisting peripheral lesions, the data are more confusing. While the absence of such lesions is not protective against detachment, the contralateral eyes of patients with so-called dangerous lesions may remain detachment-free for a very long time without any treatment. We think that the best prophylactic treatment consists of an equatorial 360 degrees argon laser photocoagulation, with the following indications: giant tear, any break, and peripheral degenerations that lead to a progressive thinning of the inner retina. Care must be taken not to perform heavy photocoagulation therapy on eyes harboring a cellular, densified vitreous.
1969年10月1日至1979年12月31日期间，1148例患者接受了视网膜脱离（RD）手术，随访至1983年6月30日。本研究排除了非特发性视网膜脱离，重点关注与另一只眼睛脱离相关的危险因素。根据这一时间标准，另一只眼睛目前的视网膜脱离发生率为4.03%：在970例患者中，有39只眼睛在首次检查时另一只眼睛可检查且无任何视网膜脱离。采用X²检验进行统计分析表明，男性患者（p<0.025）和高度近视眼（p<0.025）风险更高；第一只眼睛出现巨大裂孔（70度及以上）也是一个重要的危险因素。对于先前存在的周边病变，数据则更令人困惑。虽然没有此类病变并不能预防视网膜脱离，但患有所谓危险病变患者的对侧眼睛在未经任何治疗的情况下可能很长时间都不会发生视网膜脱离。我们认为，最佳的预防性治疗是进行360度赤道部氩激光光凝，适应症如下：巨大裂孔、任何裂孔以及导致视网膜内层逐渐变薄的周边变性。对于存在细胞性、致密玻璃体的眼睛，必须小心避免进行过度的光凝治疗。
