Ivanisević M
Department of Ophthalmology, University Hospital, Split, Croatia.
Acta Med Croatica. 1995;49(4-5):207-9.
During the last two years, 79 consecutive patients (i.e. eyes) with rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy (PVR), stages B and CP according to the classification of Machemer and associates, were treated. Conventional retinal surgery (scleral buckling) was used. Retina was successfully reattached in 54 (68.4%) eyes in the early postoperative period. Thirty-five (81.4%) out of 43 patients with PVR detachment stage B, and 19 (52.8%) out of 36 patients with PVR detachment stage CP achieved total retinal attachment. The difference was statistically significant (p = 0.006). In stage CP, larger areas of retinal involvement by fixed retinal folds are inversely related to the rate of anatomical success. A higher degree of preoperative PVR means less success of conventional retinal detachment surgery, so it is advised to apply a conventional surgical technique up to CP-6 stage of PVR, whereas in more advanced stages of PVR pars plana vitrectomy is needed.
在过去两年中,对79例连续性孔源性视网膜脱离(RRD)合并增生性玻璃体视网膜病变(PVR,根据Machemer及其同事的分类为B级和CP级)患者(即患眼)进行了治疗。采用了传统的视网膜手术(巩膜扣带术)。术后早期,54只(68.4%)患眼的视网膜成功复位。43例B级PVR脱离患者中有35例(81.4%)、36例CP级PVR脱离患者中有19例(52.8%)实现了视网膜完全复位。差异具有统计学意义(p = 0.006)。在CP级,固定视网膜皱褶累及的视网膜面积越大,解剖复位成功率越低。术前PVR程度越高,传统视网膜脱离手术的成功率越低,因此建议在PVR的CP-6级之前应用传统手术技术,而在PVR的更晚期阶段则需要进行玻璃体切割术。