Ciliary body edema after scleral buckling surgery for rhegmatogenous retinal detachment
Ciliary body edema after scleral buckling surgery for rhegmatogenous retinal detachment
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DOI：
10.1016/j.ophtha.2005.09.023
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发表时间：
2006-01-01
期刊：
影响因子：
13.7
通讯作者：
Oshika, T
中科院分区：
文献类型：
--
作者：
Kawana, K;Okamoto, F;Oshika, T
目的：孔源性视网膜脱离巩膜扣带术后，部分病例会发生脉络膜脱离及前房变浅。据报道，术后闭角型青光眼发生率为4%。据推测，局部巩膜扣带压迫导致睫状体水肿和角度变窄。本研究旨在通过超声生物显微镜定量评价巩膜扣带术前后睫状体厚度和AC深度（ACD）的变化。设计：前瞻性连续病例系列。参与者：44例患者的46只眼。（43.7 +/-18.1岁[平均值+/-标准差]）接受孔源性RD手术。术前、术后3、7、14、28天分别测量睫状体厚度和ACID。超声生物显微镜用于评估ACID和睫状体厚度。主要结果测量：睫状体厚度和ACID变化的时间过程。结果：手术导致术后3、7和14天睫状体厚度显著增加（P <0.0001，Bonferroni多重比较）。睫状体水肿在术后3天达到高峰，随后逐渐减少。术后第3天和第7天，环扎组的睫状体厚度在统计学上大于节段性加压组（P <0.001，Student t检验）。术后3天，屈曲方向的睫状体明显比对侧厚（P = 0.0079）。在环扎组，视网膜复位手术显着降低ACID术后3天（P = 0.018），而没有显着的波动被发现在buckling group.Conclusions：即使没有明显的脉络膜脱离和浅AC，亚临床睫状体水肿存在于所有眼睛的各个方向至少1个月后，巩膜扣带术。巩膜扣带方向的睫状体水肿较其他部位严重。用环扎带治疗的眼睛比单独用节段性加压术治疗的眼睛表现出更大的睫状体水肿。
Purpose: Choroidal detachment and anterior chamber (AC) shallowing develop in some cases after scleral buckling surgery for rhegmatogenous retinal detachment (RD). Postoperative angle-closure glaucoma has been reported to occur in 4% of cases. It is supposed that compression by the local scleral buckling induces ciliary body edema and angle narrowing. This study aimed to evaluate quantitatively the time course of changes in ciliary body thickness and AC depth (ACD) before and after the scleral buckling procedure using ultrasound biomicroscopy.Design: Prospective consecutive case series.Participants: Forty-six eyes of 44 patients (43.7 +/- 18.1 years old [mean +/- standard deviation]) undergoing rhegmatogenous RD surgery.Methods: Ciliary body thickness and ACID were measured before and 3, 7, 14, and 28 days after the procedure. Ultrasound biomicroscopy was used to evaluate ACID and ciliary body thickness.Main Outcome Measure: Time course of changes in ciliary body thickness and ACID.Results: The surgery caused significant increases in ciliary body thickness at 3, 7, and 14 days postoperatively (P < 0.0001, Bonferroni multiple comparison). Ciliary body edema reached its peak 3 days after surgery, followed by a gradual decrease thereafter. Ciliary body thickness in the encircling group was statistically greater than in the segmental buckling group at 3 and 7 days postoperatively (P < 0.001, Student's t test). The ciliary body was significantly thicker in the direction of buckling than on the opposite side 3 days after surgery (P = 0.0079). In the encircling group, retinal reattachment surgery significantly decreased ACID 3 days after surgery (P = 0.018), whereas no significant fluctuations were found in the buckling group.Conclusions: Even without apparent choroidal detachment and a shallow AC, subclinical ciliary edema existed in all directions of all eyes for at least 1 month after the scleral buckling procedure. The ciliary body in the direction of scleral buckling showed greater edema than the other areas. Eyes treated with the encircling band showed greater ciliary edema than those treated with segmental buckling alone.