Ie D, Glaser B M, Sjaarda R N, Thompson J T, Steinberg L E, Gordon L W
Retina Institute of Maryland, Baltimore 21204.
Retina. 1994;14(4):323-8. doi: 10.1097/00006982-199414040-00005.
A technique for managing giant retinal tears without proliferative vitreoretinopathy (PVR) is presented, and visual outcome, anatomic reattachment, and postoperative complications are discussed.
A total of 25 consecutive cases of retinal detachment from giant retinal tears in eyes without PVR that had not previously undergone surgery were reviewed. A surgical technique combining pars plana vitrectomy, perfluoro-octane, and fluid-gas exchange was used. Scleral buckling was performed in 23 (92%) of 25 eyes, and pars plana lensectomy was performed in 11 (69%) of the 16 phakic eyes. A minimum follow-up period of 6 months was documented in each case.
Of the 25 eyes, redetachment occurred in 3 (12%) after the initial procedure, and further surgery was necessary to successfully reattach the retina. A total of 9 secondary procedures were performed in 7 (28%) of the 25 eyes. Final retinal reattachment was achieved in all 25 eyes. Final Snellen visual acuity was 20/80 or better in 18 (72%) patients and 20/200 or better in 21 (84%) patients.
The anatomic and visual results of this method of surgical treatment of giant retinal tears without PVR compare favorably to those achieved with techniques that use a nonbuckling approach, but with reduced ocular morbidity.
介绍一种治疗无增殖性玻璃体视网膜病变（PVR）的巨大视网膜裂孔的技术，并讨论其视觉效果、解剖复位情况及术后并发症。
回顾了25例未经手术治疗的无PVR的巨大视网膜裂孔所致视网膜脱离的连续病例。采用了一种联合玻璃体切割术、全氟辛烷和液-气交换的手术技术。25只眼中的23只（92%）进行了巩膜扣带术，16只晶状体眼中的11只（69%）进行了晶状体平坦部切除术。每例均记录了至少6个月的随访期。
25只眼中，3只（12%）在初次手术后发生视网膜再脱离，需要进一步手术才能成功使视网膜复位。25只眼中的7只（28%）共进行了9次二次手术。所有25只眼最终均实现了视网膜复位。18例（72%）患者的最终Snellen视力达到20/80或更好，21例（84%）患者的最终视力达到20/200或更好。
这种治疗无PVR的巨大视网膜裂孔的手术方法的解剖和视觉效果与采用非扣带术式的技术相比具有优势，但眼部发病率较低。
