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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应用:一项多中心试验的结果

Transscleral diode laser retinopexy in retinal detachment surgery: results of a multicenter trial.

作者信息

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

机构信息

Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.

出版信息

Retina. 1998;18(5):399-404.

PMID:9801032
Abstract

PURPOSE

To evaluate the safety and efficacy of transscleral diode laser for retinopexy in rhegmatogenous retinal detachment surgery in a multicenter trial.

METHODS

Seventy-two 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.

RESULTS

Information from follow-up of 6 months or longer 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's 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 perhaps to have contributed to initial surgical failure. The other complications had no known adverse effects. Complications were significantly associated with the physician's experience in using transscleral laser retinopexy.

CONCLUSIONS

In this multicenter study, 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.

摘要

目的

在一项多中心试验中评估经巩膜二极管激光用于孔源性视网膜脱离手术中视网膜固定术的安全性和有效性。

方法

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。

结果

65只眼获得了6个月或更长时间的随访信息。其中58只(89%)眼通过单次手术在6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、10只眼出现局限性视网膜内出血、3只眼出血扩展至玻璃体腔。1例中,出血可能导致了初始手术失败。其他并发症无已知不良影响。并发症与医生使用经巩膜激光视网膜固定术的经验显著相关。

结论

在这项多中心研究中,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。

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