SCI TOP 10

当前位置:首页>SCI TOP 10

巩膜扣带术与再次玻璃体切除术治疗硅油填塞眼复发性下视网膜脱离的预后比较

Wei Y, Wu G, Xu K, et al.

期刊名称:Acta Ophthalmologica

卷期:2016年第94卷第7期

摘要

目的:在这项回顾性研究中,我们评估了巩膜扣带术(SB)与再次玻璃体切除术治疗原发性玻璃体切除术后硅油(SiO)填塞眼复发性下视网膜脱离(RD)的解剖学预后。方法:本研究纳入了103例患者(103只眼)。所有患者在原发性玻璃体切除术后6个月内SiO填充眼发生复发性下RD,并采用SB或再次玻璃体切除术治疗。基于不同的外科手术将患者分为两组:SB组(49只眼)和再次玻璃体切除组(54只眼)。再次手术后测量视网膜的解剖学复位。根据原发性玻璃体切除术后不同术后期不同的视网膜增生状态,我们还比较两个特定术后期早期(≤1个月)和晚期(1-6个月)两种手术过程的解剖学预后。结果:SB和再次玻璃体切除术组的视网膜复位率类似(65.3%:72.2%,p = 0.449)。在再次玻璃体切除术组,早期和晚期的视网膜复位率相似(70.8%:73.3%,p = 0.839)。然而,SB组早期的视网膜复位率明显高于晚期(80.8%:47.8%,p = 0.016)。在早期手术组中,与再次玻璃体切除组相比,SB组的视网膜复位率相似(80.8%:70.8%,p = 0.411)。而在晚期手术组中,再次玻璃体切除组的视网膜复位率比SB组高(73.3%:47.8%,p = 0.058)。结论:对于填充SO眼复发性下RDSB手术与再玻璃体切除术相比,提供了类似的治疗效果和令人满意的解剖学预后。对于原发性玻璃体切除术后早期(≤1个月)复发性下RD眼,SB手术可能是一个更好的选择,因为它可导致较少的并发症;而在原发性玻璃体切除术后晚期(1-6个月),可以推荐再次玻璃体切除术,特别是对于具有严重前增殖性玻璃体视网膜病变和视网膜垂直变形眼。

PURPOSE:In this retrospective study we evaluated the anatomic outcomes of scleral buckling (SB) versus re-vitrectomy for the treatment of recurrent inferior retinal detachment (RD) in silicone oil (SiO) tamponade eyes after primary vitrectomy.METHODS:There were 103 patients (103 eyes) enrolled in this study. All patients had recurrent inferior RD in the SiO-filled eyes within 6months after the primary vitrectomy, and were treated by either SB or re-vitrectomy. Patients were divided into two groups based on different surgical procedures: the SB group (49 eyes) and the re-vitrectomy group (54 eyes). Anatomic reattachment of the retina was measured after reoperation. Based on different retinal proliferation states in different postoperative periods after primary vitrectomy, we also compared the anatomic outcomes of the two surgical procedures in two specific postoperative periods, early period (1month) and late period (1-6months).RESULTS:The SB and re-vitrectomy groups exhibited similar retinal reattachment rate (65.3% versus 72.2%, p=0.449) after reoperation. In the re-vitrectomy group, the retinal reattachment rate was similar in the early period and the late period (70.8% versus 73.3%, p=0.839). However, the retinal reattachment rate was significantly higher in the early period than that of the late period (80.8% versus 47.8%, p=0.016) in the SB group. In the early surgery groups, the retinal reattachment rate was similar in the SB group compared to the re-vitrectomy group (80.8% versus 70.8%, p=0.411). While in the late surgery groups, retinal reattachment rate was trended higher in the re-vitrectomy group compared to the SB group (73.3% versus 47.8%, p=0.058).CONCLUSION:For recurrent inferior RD in SO-filled eyes, SB surgery provides similar therapeutic effectiveness with satisfactory anatomic outcomes compared to the re-vitrectomy. For eyes with recurrent inferior RD in the early period (1month) after primary vitrectomy, SB surgery may be a better choice since it causes less complication; while in the late period (1-6months) after primary vitrectomy, re-vitrectomy may be recommended, especially for the eyes with severe anterior proliferative vitreoretinopathy and retinal foreshortening.


点击下载

CopyRight 2016  兴齐100版权所有 京ICP证060955号
技术支持:示剑网络   http://100.sinqi.com/