Kertes P J, Wafapoor H, Peyman G A, Calixto N, Thompson H
LSU Eye Center, Louisiana State University Medical Center, School of Medicine, New Orleans 70112, USA.
Ophthalmology. 1997 Jul;104(7):1159-65. doi: 10.1016/s0161-6420(97)30168-7.
The purpose of the study was to determine the predictors of success and evaluate the use of perfluoroperhydrophenanthrene as an intraoperative and postoperative tool in the management of giant retinal tears in a multicentered collaborative study.
Multicentered prospective case series.
Twenty-three centers consecutively enrolled 162 eyes of 161 patients with retinal tears 90 degrees or greater in circumferential extent.
Perfluoroperhydrophenanthrene was used as an intraoperative surgical adjunct in all cases and left after surgery in 16 eyes (9.9%).
Retinal reattachment and visual acuity.
Intraoperative reattachment was achieved in 158 eyes (97.5%); 147 eyes (90.7%) remained attached at their most recent follow-up. Seventy-nine eyes (48.8%) experienced an improvement in their visual acuity, 26 eyes (16.0%) remained unchanged, and 57 (35.2%) worsened. Recurrent retinal detachment occurred in 80 patients (49.4%). Other significant postoperative complications included cataract formation in 20 (39.2%) of 51 eyes, macular pucker in 12 (7.4%), corneal decompensation in 10 (6.2%), and hypotony (intraocular pressure equal to or less than 5 mmHg) in 9 (5.6%). A chi-square analysis of preoperative characteristics showed that hypotony (P = 0.007), macular detachment (P = 0.020), a history of cataract extraction (P = 0.003), poor visual acuity (P = 0.000), giant tear extent greater than 180 degrees (P = 0.004), and higher grade proliferative vitreoretinopathy (P = 0.000) all predicted a poor visual outcome. Vitreon (Vitrophage, Inc., Lyons, IL) was left in 16 eyes (9.9%) for an extended postoperative retinal tamponade for between 3 and 1034 days (mean, 87.2 days). The Vitreon was well tolerated, and these eyes experienced a similar outcome and rate of retinal reattachment to the rest of the group.
Vitreon is a safe and useful adjunct to pars plana vitrectomy in the management of giant retinal tears and may, additionally, be the perfluorocarbon liquid that can be used most safely as a temporary postoperative tool for extended retinal tamponade, reinforcing its role as a useful adjunct in the management of these complex retinal detachments.
在一项多中心合作研究中，本研究旨在确定成功的预测因素，并评估全氟菲烷作为术中及术后工具在巨大视网膜裂孔治疗中的应用。
多中心前瞻性病例系列研究。
23个中心连续纳入了161例视网膜裂孔圆周范围达90度或更大的患者的162只眼。
在所有病例中，全氟菲烷均用作术中手术辅助剂，16只眼（9.9%）术后保留。
视网膜复位和视力。
158只眼（97.5%）术中实现视网膜复位；在最近一次随访时，147只眼（90.7%）保持附着。79只眼（48.8%）视力改善，26只眼（16.0%）视力无变化，57只眼（35.2%）视力恶化。80例患者（49.4%）发生视网膜脱离复发。其他显著的术后并发症包括51只眼中20只眼（39.2%）形成白内障，12只眼（7.4%）发生黄斑皱襞，10只眼（6.2%）发生角膜失代偿，9只眼（5.6%）发生低眼压（眼压等于或低于5 mmHg）。术前特征的卡方分析显示，低眼压（P = 0.007）、黄斑脱离（P = 0.020）、白内障摘除史（P = 0.003）、视力差（P = 0.000）、巨大裂孔范围大于180度（P = 0.004）以及更高等级的增殖性玻璃体视网膜病变（P = 0.000）均预示视力预后不良。16只眼（9.9%）术后保留Vitreon（Vitrophage公司，伊利诺伊州里昂）进行长达3至1034天（平均87.2天）的视网膜填塞。Vitreon耐受性良好，这些眼与该组其他眼的视网膜复位结果和比率相似。
在巨大视网膜裂孔的治疗中，Vitreon是玻璃体切除术的一种安全且有用的辅助剂，此外，它可能是最安全的可作为术后视网膜延长填塞临时工具的全氟碳液体，强化了其在这些复杂视网膜脱离治疗中作为有用辅助剂的作用。
