Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries.
Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries.
复制标题
DOI：
10.3389/fmed.2021.801068
复制
发表时间：
2021
影响因子：
3.9
通讯作者：
Ma Z
中科院分区：
文献类型：
--
作者：
Chen H;Yang J;Wang C;Feng X;Feng K;Ma Z
目的探讨经巩膜褥式巩膜悬吊术（TSS）和眼内悬吊术（IOS）治疗脉络膜撕脱伤的远期疗效。前瞻性队列，基于医院的研究。共24例诊断为脉络膜撕脱的患者入组本研究。术前收集患者的人口统计学特征、创伤基线信息、最佳矫正视力（BCVA）和眼压（IOP），并记录术前或术中地球仪的解剖学异常。所有患者均被诊断为脉络膜撕脱，并在玻璃体切除术期间接受脉络膜剥脱治疗，术后功能变量包括BCVA和IOP，解剖变量包括视网膜和脉络膜复位率，以及硅油迁移率，这些都在术后至少1年的定期随访中记录。所有开放性地球仪损伤的患者均累及III区，70.8%的患者出现两个象限的脉络膜撕脱，29.2%的患者出现一个象限的脉络膜撕脱;此外，所有患者均有视网膜脱离（RD）并发症，其中58.3%的患者有闭合性漏斗状视网膜脱离。TSS应用于19例患者，IOS应用于5例患者。术后，每次随访时均观察到LogMAR BCVA显著改善，从术前的3.57 ± 0.69改善至末次随访时的2.82 ± 0.98（p <0.05），无光感（NLP）比例也从69.6%降低至37.5%。眼压由术前的6.4 ± 4.1mmHg升高至末次随访时的11.3 ± 4.3mmHg（p <0.05）。91.7%的患者实现了脉络膜复位; 2例患者在术后3个月观察到硅油迁移，并接受了脉络膜上硅油引流和巩膜扣带术。同时，95.8%的患者观察到视网膜附着，仅1例患者因术后增生性玻璃体视网膜病变发生部分RD，并进行了二次玻璃体切除术;所有患者在末次随访时均观察到视网膜和脉络膜完全附着。最终，4例患者无硅油，20例患者硅油依赖。脉络膜剥离术是一种有效的固定脉络膜撕脱伤的方法，可显著提高最佳矫正视力，维持眼压，有效提高脉络膜视网膜复位率和眼球保存率。
To explore the long-term efficacy of novel choroidal suturing methods including trans-scleral mattress suturing (TSS) and intraocular suturing (IOS) in the treatment of choroidal avulsion. Prospective cohort, hospital-based study. A total of 24 patients who were diagnosed with choroidal avulsion were enrolled in this study. The demographic characteristics, baseline information of trauma, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were collected before surgery, and the anatomic abnormities of the globe were recorded before or during surgery. All patients were diagnosed with choroidal avulsion and underwent choroid suturing treatment during vitrectomy, postoperative functional variables including BCVA and IOP, anatomic variables including retinal and choroidal reattachment rate, and silicone oil migration rate, which were recorded at the regular follow-ups at least 1 year after surgery. All patients with open globe injury involved zone III, 70.8% of the patients presented with two quadrants of the avulsed choroid, and 29.2% with one quadrant involved; moreover, all patients had complications with retinal detachment (RD), of which 58.3% of patients had closed funnel retinal detachment. TSS was applied in nineteen patients and IOS in five patients. Postoperatively, a significant improvement on LogMAR BCVA was observed at each follow-up from 3.57 ± 0.69 before surgery to 2.82 ± 0.98 at the last follow-up (p < 0.05), and the proportion of no light perception (NLP) was also reduced from 69.6 to 37.5%. IOP was markedly elevated from 6.4 ± 4.1 mmHg preoperatively to 11.3 ± 4.3 mmHg at the last follow-up (p < 0.05). Choroidal reattachment was achieved in 91.7% of patients; two patients were observed with silicone oil migration at 3 months after surgery and underwent drainage of suprachoroidal silicone oil and sclera buckling. Meanwhile, retinal attachment was observed in 95.8% of patients, only one patient developed partial RD due to postoperative proliferative vitreoretinopathy, and secondary vitrectomy was performed; all patients were observed with complete retinal and choroidal attachment at the last follow-up. Eventually, four patients were silicone oil-free, and 20 patients were silicone oil-dependent. Choroidal suturing proved to be an effective method to fix the avulsed choroid, which greatly improved the BCVA and maintained the IOP, and efficiently increased the choroidal and retinal reattachment rate and preservation of the eyeball.
登录
查看更多内容
DOI：
10.1097/iae.0000000000000261
发表时间：
2015-01-01
影响因子：
3.3
作者：
Sheng, Iris;Bauza, Alain;Bhagat, Neelakshi
通讯作者：
Bhagat, Neelakshi
DOI：
10.3969/j.issn.1000-4432.2011.03.004
发表时间：
2011-09-01
期刊：
Eye science
影响因子：
--
作者：
Ma, Jin;Tong, Yuhua;Ye, Panpan
通讯作者：
Ye, Panpan
影响因子：
2.9
作者：
Martin-Prieto S;Álvarez-Peregrina C;Thuissard-Vasallo I;Catalina-Romero C;Calvo-Bonacho E;Villa-Collar C;Sánchez-Tena MÁ
通讯作者：
Sánchez-Tena MÁ
影响因子：
4.2
作者：
Feng, Kang;Hu, Yun Tao;Ma, Zhizhong
通讯作者：
Ma, Zhizhong
影响因子：
4.4
作者：
Ho, I-Van;Fernandez-Sanz, Guillermo;Chang, Andrew A.
通讯作者：
Chang, Andrew A.