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玻璃体切除术治疗难治性房水迷流综合征的效果

Al, B.A.G.Y., Al-Mahmood, A.M., Khandekar, R., Abboud, E.B., Edward, D.P., Kozak, I.

期刊名称:Retina

卷期:2017年第37卷第10期

摘要

摘要:目的:旨在确定玻璃体切除术(PPV)以及辅助手术治疗药物难治性房水迷流综合征的疗效和并发症。方法:进行了一项回顾性综述,对2002年至2007年在国王哈立德眼科专科医院接受难治性房水迷流综合征连续眼进行了研究。患者接受双口和三口玻璃体切除术(PPV)和辅助手术包括晶体切除术与后囊切除术,玻璃体-环带切除术和溶栓术治疗。主要预后指标包括解剖学成功,功能性成功以及与预后相关的因素。结果:对69眼进行了评估,平均随访17.6±3.8个月(3-156个月)。 接受PPV作为主要手术的眼中,62只眼(90%)取得了解剖学成功,54只眼(78%)取得功能性成功。与改变房水流向错误和最佳矫正视力两线改善显着相关眼内压下降相关因素包括临床表现后4周内的手术治疗(P = 0.004)和术前眼压(P = 0.001)。双口PPV和标准三口PPV的成功率相似(P = 0.7)。手术和术后并发症包括两只眼视网膜脱离和一只眼眼内炎。结论:PPV对于药物治疗难治性房水迷流综合征有效。双口或三口PPV没有改变成功率,但早期手术可改善解剖学和功能性预后。

PURPOSE:To determine the efficacy and complications of pars plana vitrectomy (PPV) and adjunct surgeries for aqueous misdirection refractory to medical therapy.METHODS:A retrospective review of consecutive eyes with refractory aqueous misdirection at the King Khaled Eye Specialist Hospital between 2002 and 2010. Patients underwent two-port and three-port pars plana vitrectomy (PPV) with adjunct procedures including pars plana lensectomy combined with posterior capsulectomy, hyaloido-zonulo-iridectomy, and synechiolysis. Main outcome measures included anatomical success, functional success, and factors associated with the outcomes.RESULTS:Sixty-nine eyes were evaluated over a mean follow-up period of 17.6 ± 3.8 months (3-156 months). Anatomical success was achieved in 62 eyes (90%) and functional success in 54 eyes (78%) that underwent PPV as a primary surgery. The factors associated with the altering misdirected aqueous flow and reducing intraocular pressure significantly associated with a two-line improvement of best-corrected visual acuity included surgical treatment within 4 weeks of presentation (P = 0.004) and preoperative intraocular pressure (P = 0.001). The success of two-port PPV and standard three-port PPV was similar (P = 0.7). The intraoperative and postoperative complications included retinal detachment in two eyes and endophthalmitis in one eye.CONCLUSION:The PPV was effective for managing aqueous misdirection refractory to medical therapy. Two-port or three-port PPV did not change the success rate but early surgery improved both anatomical and functional outcomes.


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