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经巩膜二极管激光视网膜光凝术在视网膜脱离手术中的初步试验

Pilot trial of transscleral diode laser retinopexy in retinal detachment surgery.

作者信息

Haller J A, Lim J I, Goldberg M F

机构信息

Wilmer Ophthalmological Institute, Johns Hopkins Medical Institutions, Baltimore, Md.

出版信息

Arch Ophthalmol. 1993 Jul;111(7):952-6. doi: 10.1001/archopht.1993.01090070070022.

Abstract

OBJECTIVE

To evaluate the safety and efficacy of the transscleral diode laser for retinopexy in rhegmatogenous retinal detachments.

DESIGN

Ten consecutive patients with primary rhegmatogenous retinal detachments underwent scleral buckling surgery, using the transscleral diode laser for retinopexy. Patients were followed up for at least 6 months.

STUDY PARTICIPANTS

Ten patients with primary rhegmatogenous retinal detachments were enrolled. Patients with chronic detachments, a retinal break greater than 90 degrees, history of uveitis or infectious retinopathy, or proliferative vitreoretinopathy were excluded.

MAIN OUTCOME MEASURE

Retinal reattachment. Secondary measures: visual acuity and complications, including choroidal, retinal, and vitreous hemorrhage, inflammation, and scleral damage.

RESULTS

By 6 months, nine of 10 retinas were successfully repaired following only one operation. The retina of the 10th patient redetached at 6 1/2 weeks owing to proliferative vitreoretinopathy. Following a vitrectomy and retinal reattachment procedure, the retina of the 10th patient has remained attached for 1 year. No significant complications were encountered with the laser retinopexy, although small presumed breaks in Bruch's membrane occurred in three eyes and a moderate scleral thermal effect occurred in two. Visual results in the postoperative course were comparable to those achieved previously with cryotherapy.

CONCLUSION

In this pilot series, transscleral diode laser retinopexy served as a safe and effective means of obtaining chorioretinal adhesion in retinal detachment surgery.

摘要

目的

评估经巩膜二极管激光用于孔源性视网膜脱离视网膜固定术的安全性和有效性。

设计

连续10例原发性孔源性视网膜脱离患者接受巩膜扣带手术,使用经巩膜二极管激光进行视网膜固定术。对患者进行至少6个月的随访。

研究对象

纳入10例原发性孔源性视网膜脱离患者。排除慢性脱离、视网膜裂孔大于90度、有葡萄膜炎或感染性视网膜病变病史或增生性玻璃体视网膜病变的患者。

主要观察指标

视网膜复位。次要指标:视力和并发症,包括脉络膜、视网膜和玻璃体出血、炎症以及巩膜损伤。

结果

到6个月时,10只眼中有9只眼仅经一次手术即成功修复。第10例患者的视网膜在6.5周时因增生性玻璃体视网膜病变而复脱。在玻璃体切除术和视网膜复位手术后,第10例患者的视网膜已保持附着1年。激光视网膜固定术未出现明显并发症,尽管3只眼中出现了Bruch膜小的疑似破裂,2只眼中出现了中度巩膜热效应。术后视力结果与先前冷冻疗法所取得的结果相当。

结论

在这个初步系列研究中,经巩膜二极管激光视网膜固定术是视网膜脱离手术中获得脉络膜视网膜粘连的一种安全有效的方法。

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