Catheter-guided suprachoroidal buckling of rhegmatogenous retinal detachments secondary to peripheral retinal breaks
Catheter-guided suprachoroidal buckling of rhegmatogenous retinal detachments secondary to peripheral retinal breaks
复制标题
导管引导下脉络膜上扣带术治疗周边视网膜裂孔继发的孔源性视网膜脱离
DOI：
10.1007/s00417-016-3530-8
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Rezende F
中科院分区：
文献类型：
--
作者：
Mikhail M;El Rayes EN;Kojima K;Ajlan R;Rezende F
目的评价应用特制导管行脉络膜上腔环扎术(SCB)治疗继发于周边视网膜裂孔的孔源性视网膜脱离(RRD)的功能和解剖结果。受试者接受SCB治疗继发于单个或多个视网膜裂孔的RRD。脉络膜上压痕是通过在骨折上方脉络膜上间隙引入粘弹性材料，使用照明的450Tμm宽的柔尖导管实现的。这使得脉络膜上穹顶和脉络膜-视网膜对位得以产生。47眼(80%)单纯行SCB术，15眼(20%)联合25G玻璃体切除术。结果平均最佳矫正视力由术前的对数矫正视力0.82(20/132)提高到0.22(20/33)(p<； 0.0001)。一次手术再植入率为92%(57/62)。所有患者最终视网膜复位率为100%。当按晶状体状态、黄斑受累或破裂位置分层时，单次手术解剖成功率没有显著差异。结论采用特殊设计的柔性导管行脉络膜上腔环扎术是治疗继发于周边视网膜裂孔的RRD的一种安全有效的方法。
PurposeTo evaluate functional and anatomic outcomes of eyes undergoing suprachoroidal buckling (SCB) using a specially designed catheter for the management of rhegmatogenous retinal detachment (RRD) secondary to peripheral retinal breaks.MethodsRetrospective cohort study of 62 eyes of 62 patients. Subjects underwent SCB for the management of RRD secondary to single or multiple retinal breaks. Suprachoroidal indentation was achieved through the introduction of viscoelastic material in the suprachoroidal space overlying the break using an illuminated, 450 μm-wide, flex-tip catheter. This allowed for the creation of a suprachoroidal dome and chorio-retinal apposition. Forty-seven eyes (80 %) underwent SCB alone, while 15 eyes (20 %) were combined with 25-G pars-plana vitrectomy. Cryopexy and laserpexy were used in 38 (61 %) and 24 of eyes (39 %) respectively.ResultsMean pre-operative best-corrected visual acuity (BCVA) improved from logMAR 0.82 (20/132) to 0.22 (20/33) (p< 0.0001). The single surgery reattachment rate was 92 % (57/62.) Final retinal reattachment was achieved in all eyes (100 %). No significant difference was observed in single-surgery anatomic success rates when stratified by lens status, macular involvement, or break location. There were no major intra- or post-operative complications.ConclusionSuprachoroidal buckling using a special-design, flexible catheter is a safe and effective procedure for the management of RRD secondary to peripheral retinal breaks.