Starzycka M, Górniak-Bednarz A, Ortyl E, Starzycka-Bigaj E
Katedry i Kliniki Okulistyki Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
Klin Oczna. 1996 Mar;98(3):225-8.
To evaluate the usefulness of conventional methods in retinal detachment (RD) surgery basing on the relationship between factors characterizing clinical picture of the RD, the type and course of surgical procedures and the retinal reattachment.
252 patients (252 eyes), operated on in the last 5 years in our clinic were enrolled in the studies. There were 120 men and 132 women, aged 9 to 83, mean 53. In all cases scleral buckling procedures with silicone band or sponge and cryocoagulation of the breaks were used. The relationship between retinal reattachment and the following parameters were examined: visual acuity, retinal degenerations, myopia, extent of the detachment, number and kinds of breaks, macular involvement, state of vitreous, PVR, intraocular pressure, extent of scleral buckling, subretinal fluid drainage and intra- or post-operative complications.
Retinal reattachment was achieved in 82% of the eyes with one operation and additionally in 7% after reoperation. The significant relationship was found between: visual acuity, intraocular pressure, extent of the detachment, number of breaks, PVR, extent of scleral buckling and retinal reattachment.
PVR is a significant cause of failure in RD surgery with conventional methods and PVR grade C is the threshold beyond which the percentage of reattachments decreases to about 50%. Value of other risk factors, determining severity of RD is not certain for prognosis. Cerclage with silicone band is a method of choice in the majority of RD with PVR grade B and C. Our observations do not confirm the reports of severe complications caused by cerclage, which might be connected with excessive tightening of the band.
基于视网膜脱离（RD）临床症状特征、手术类型及过程与视网膜复位之间的关系，评估传统方法在RD手术中的实用性。
选取过去5年在我院接受手术的252例患者（252只眼）纳入研究。其中男性120例，女性132例，年龄9至83岁，平均53岁。所有病例均采用硅胶带或海绵巩膜扣带术及裂孔冷凝术。检查视网膜复位与以下参数之间的关系：视力、视网膜变性、近视、脱离范围、裂孔数量及类型、黄斑受累情况、玻璃体状态、增殖性玻璃体视网膜病变（PVR）、眼压、巩膜扣带范围、视网膜下液引流及术中或术后并发症。
82%的患眼一次手术即实现视网膜复位，再次手术后另外7%的患眼实现视网膜复位。发现视力、眼压、脱离范围、裂孔数量、PVR、巩膜扣带范围与视网膜复位之间存在显著关系。
PVR是传统方法治疗RD手术失败的重要原因，C级PVR是一个阈值，超过该阈值视网膜复位率降至约50%。其他决定RD严重程度的危险因素对预后的价值尚不确定。对于大多数B级和C级PVR的RD患者，硅胶带环扎术是首选方法。我们的观察结果不支持有关环扎术会导致严重并发症的报道，这些并发症可能与环扎带过度收紧有关。
