Böker T, Schmitt C, Mougharbel M
Universitäts-Augenklinik, Bonn, Germany.
Ger J Ophthalmol. 1994 Mar;3(2):73-8.
We analyzed 133 consecutive cases of primary retinal detachment treated by pneumatic retinopexy (PR). The postoperative follow-up period was at least 6 months (mean, 16.7 months; maximum, 36 months). In all, 97 cases (72.9%) were successfully treated by a single PR. In 19 cases (14.3%) primary reattachment was not achieved. In another 17 cases (12.8%) redetachment occurred. Redetachment was never observed later than 6 months following PR. It was caused by missed or new retinal tears in 8 eyes (6.0%) and by proliferative vitreoretinopathy in 7 eyes (5.3%). A final reattachment rate of 98.5% was achieved. Preoperative factors suggesting primary failure or redetachment were (1) extensive retinal detachment (P < 0.01), (2) pseudo- or aphakia (P = 0.01), (3) the retinal status of the fellow eye (P < 0.05), and (4) poor visual acuity in cases of attached macula (P < 0.01). In cases with preoperatively detached macula, visual acuity (VA) recovered considerably better following PR than following conventional buckling procedures. As compared with cases of successful PR, recovery of VA in all eyes requiring reoperation was significantly reduced. It was, however, still equivalent to the VA of eyes treated by scleral buckling. Surgical success is influenced by preoperative factors such as pseudo- or aphakia, extensive retinal detachment, poor initial VA in cases of attached macula, or the state of the fellow eye. These factors have to be taken into consideration in decisions for or against PR. The anatomical and functional outcome proves the value of this technique in the treatment of primary rhegmatogenous retinal detachment.
我们分析了133例连续接受气性视网膜固定术（PR）治疗的原发性视网膜脱离病例。术后随访期至少为6个月（平均16.7个月；最长36个月）。总体而言，97例（72.9%）通过单次PR成功治疗。19例（14.3%）未实现原发性视网膜复位。另有17例（12.8%）发生视网膜再脱离。视网膜再脱离从未在PR后6个月后出现。其原因是8只眼（6.0%）存在遗漏或新的视网膜裂孔，7只眼（5.3%）存在增殖性玻璃体视网膜病变。最终视网膜复位率达到98.5%。提示原发性治疗失败或视网膜再脱离的术前因素包括：（1）广泛的视网膜脱离（P<0.01），（2）假晶状体或无晶状体（P = 0.01），（3）对侧眼的视网膜状况（P<0.05），以及（4）黄斑附着的病例中视力较差（P<0.01）。在术前黄斑脱离的病例中，PR术后视力（VA）恢复明显优于传统巩膜扣带术。与PR成功的病例相比 在所有需要再次手术的眼中，VA的恢复明显降低。然而，其仍等同于巩膜扣带术治疗的眼的VA。手术成功率受术前因素影响，如假晶状体或无晶状体、广泛视网膜脱离、黄斑附着病例中初始视力差或对侧眼的状态。在决定是否进行PR时必须考虑这些因素。解剖和功能结果证明了该技术在治疗原发性孔源性视网膜脱离中的价值。
