The effect of duration of macular detachment on results after the scleral buckle repair of primary, macula-off retinal detachments
The effect of duration of macular detachment on results after the scleral buckle repair of primary, macula-off retinal detachments
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DOI：
10.1016/s0161-6420(01)00886-7
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发表时间：
2002-01-01
期刊：
影响因子：
13.7
通讯作者：
Williams, GA
中科院分区：
文献类型：
--
作者：
Hassan, TS;Sarrafizadeh, R;Williams, GA
目的：研究黄斑脱离持续时间（DMD）和患者年龄对巩膜后扣（SB）视力（VA）和解剖结果的影响。设计：回顾性、非比较性、观察性病例系列。参与者：94例连续患者（94只眼睛），原发，无并发症，无黄斑的视网膜脱离，术前VA为20/200或更差，并有黄斑功能丧失的确切历史。干预：由多名外科医生实施的标准外植巩膜扣技术。主要观察指标：视力、解剖复位和增生性玻璃体视网膜病变。结果：DMD≤10天的眼71%、DMD≤11天至6周的眼27%、DMD≥6周的眼14%的人SB术后视力达到20/40或更好。DMD持续10天或更短时间后，SB的平均VA为20/41，DMD持续11天至6周后为20/121，DMD超过6周后为20/178。在DMD治疗的1- 10天或11 - 6周期间，VA未见下降。60岁以下患者SB后平均VA为20/47，而61 - 75岁患者为20/81,76岁以上患者为20/ 96。黄斑脱离持续时间和患者年龄对SB术后最终解剖再附着、再手术率或增殖性玻璃体视网膜病变无统计学意义。结论：如果在黄斑脱离后的前10天内，用SB修复原发、简单、脱离黄斑的视网膜脱离，可获得良好的术后VA。在黄斑脱离术后11天~ 6周及6周以上的眼内修复效果优于VA。60岁及以下患者术后VA优于老年患者。黄斑脱离持续时间和患者年龄对解剖结果无显著影响。(C) 2002年由美国眼科学会发布。
Purpose: To present a current series that determined the effect of duration of macular detachment (DMD) and patient age on postscleral buckle (SB) visual acuity (VA) and anatomic results.Design: Retrospective, noncomparative, observational case series.Participants: Ninety-four consecutive patients (94 eyes) with primary, uncomplicated, macula-off retinal detachments, a preoperative VA of 20/200 or worse, and a precise history of when macular function was lost.Intervention: Standard explant scleral buckle technique performed by multiple surgeons.Main Outcome Measures: Visual acuity, anatomic reattachment, and proliferative vitreoretinopathy.Results: Visual acuity after SB of 20/40 or better was seen in 71% of eyes with a DMD of 10 days or fewer, 27% of eyes with a DMD of 11 days to 6 weeks, and 14% of eyes with a DMD of more than 6 weeks. Eyes achieved a mean VA after SB of 20/41 after a DMD of 10 days or fewer, 20/121 after a DMD of 11 days to 6 weeks, and 20/178 after a DMD of more than 6 weeks. No decrease in VA was seen within the 1- to 10-day period or the 11 days to 6 week period of DMD. Patients 60 years of age or less achieved a mean VA after SB of 20/47 compared with 20/81 for patients between 61 to 75 years of age and 20 of 96 in patients more than 76 years of age. Duration of macular detachment and patient age had no statistically significant effect on final anatomic reattachment after SB, reoperation rate, or proliferative vitreoretinopathy.Conclusions: Eyes with primary, uncomplicated, macula-off retinal detachment repaired with SB achieve excellent postoperative VA if repaired within the first 10 days of macular detachment. These results are better than the VA in eyes repaired after 11 days to 6 weeks and more than 6 weeks of macular detachment. Patients 60 years of age and younger obtained better postoperative VA than older patients. Duration of macular detachment and patient age did not significantly effect anatomic outcomes. (C) 2002 by the American Academy of Ophthalmology.