Haller J A, Blair N, de Juan E, de Bustros S, Goldberg M F, Muldoon T, Packo K, Resnick K, Rosen R, Shapiro M, Smiddy W, Walsh J
Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, USA.
Trans Am Ophthalmol Soc. 1997;95:221-30.
To evaluate the safety and efficacy of transscleral diode laser for retinopexy in rhegmatogenous retinal detachment surgery in a multicenter trial.
67 patients with primary rhegmatogenous retinal detachment underwent scleral buckling surgery, using transscleral diode laser for retinopexy, at five study centers.
72 patients with primary rhegmatogenous retinal detachments were enrolled. No patient with chronic detachment, a retinal break greater than 90 degrees, history of uveitis or infectious retinopathy, or proliferative vitreoretinopathy was enrolled. Five eyes were excluded because they required additional nonprotocol treatment at the time of surgery (vitrectomy or supplementary cryotherapy due to probe malfunction).
Retinal reattachment at six months after one operation. Secondary measures: visual acuity and complications, including choroidal, retinal, and vitreous hemorrhage, inflammation, and scleral damage.
Six months or greater follow-up information was available on 65 eyes. Retinas were attached at 6 months with a single operation in 58 (89%) of these eyes. Complications included apparent pinpoint breaks in Bruch is membrane in 15 eyes, scleral thermal effect in 14 eyes, and limited hemorrhage, which was intraretinal in 10 eyes, and extended into the vitreous in 3 eyes. In one case, hemorrhage was judged to have contributed possibly to initial surgical failure. The other complications had no known adverse effects. Complications were significantly associated with the physicians experience with transscleral laser retinopexy.
In this multicenter series, transscleral diode laser retinopexy served as a safe and effective means of creating chorioretinal adhesion during retinal reattachment surgery. Minor complications were minimized by increasing experience with the technique.
在一项多中心试验中评估经巩膜二极管激光在孔源性视网膜脱离手术中用于视网膜固定术的安全性和有效性。
在五个研究中心，67例原发性孔源性视网膜脱离患者接受了巩膜扣带手术，并使用经巩膜二极管激光进行视网膜固定术。
纳入72例原发性孔源性视网膜脱离患者。未纳入慢性视网膜脱离、视网膜裂孔大于90度、葡萄膜炎或感染性视网膜病变病史或增殖性玻璃体视网膜病变患者。5只眼被排除，因为它们在手术时需要额外的非方案治疗（玻璃体切除术或因探头故障进行补充冷冻疗法）。
一次手术后六个月视网膜复位情况。次要指标：视力和并发症，包括脉络膜、视网膜和玻璃体出血、炎症和巩膜损伤。
65只眼获得了六个月或更长时间的随访信息。其中58只眼（89%）通过单次手术在六个月时视网膜复位。并发症包括15只眼Bruch膜出现明显的针尖样裂孔、14只眼出现巩膜热效应以及有限的出血，其中10只眼为视网膜内出血，3只眼出血扩展至玻璃体。在1例中，出血被判定可能导致了最初的手术失败。其他并发症无已知不良影响。并发症与医生进行经巩膜激光视网膜固定术的经验显著相关。
在这个多中心系列研究中，经巩膜二极管激光视网膜固定术是视网膜复位手术中形成脉络膜视网膜粘连的一种安全有效的方法。通过增加对该技术的经验，将轻微并发症降至最低。
