Surgical repair of primary non-complex rhegmatogenous retinal detachment in the modern era of small-gauge vitrectomy.
Surgical repair of primary non-complex rhegmatogenous retinal detachment in the modern era of small-gauge vitrectomy.
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DOI：
10.1136/bmjophth-2020-000651
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发表时间：
2021
影响因子：
2.4
通讯作者：
Besirli CG
中科院分区：
文献类型：
--
作者：
Moinuddin O;Abuzaitoun RO;Hwang MW;Sathrasala SK;Chen XD;Stein JD;Johnson MW;Zacks DN;Wubben TJ;Besirli CG
报道玻璃体切割术（PPV）、巩膜扣合术（SB）和玻璃体/玻璃体切除术（PPV /SB）作为治疗原发性非复杂孔源性视网膜脱离（RRD）的手术治疗方法的解剖和视力结果。对751只接受PPV、SB或联合PPV/SB作为原发性非复杂性RRD手术治疗的眼睛进行了至少3个月的随访，以确定单次手术解剖成功率（SSAS）和最终解剖成功率（FAS）。患者或公众没有参与这项研究的设计、实施或报告。PPV占89.0% (n=668)， PPV/SB占6.8% (n=51)， SB占4.2% （n=32）。3个手术组的总SSAS （91.2% PPV, 84.3% PPV/SB, 93.8% SB, p=0.267）和FAS （96.7% PPV, 94.1% PPV/SB, 100.0% SB, p=0.221）。对于PPV、PPV/SB和SB组，SSAS和FAS在晶状体状态、黄斑脱离状态和是否存在下视网膜断裂方面相似。在这个大型，单一机构，回顾性病例系列中，我们报告了在现代小尺寸玻璃体切除术时代，PPV， SB或PPV/SB治疗原发性非复杂性RRD患者的手术结果。我们证明，没有辅助SB的原发性PPV提供了良好的解剖和视觉结果，而与晶状体状态、黄斑受染或病理位置无关。
To report anatomic and visual outcomes of pars plana vitrectomy (PPV), as well as scleral buckling (SB) and PPV/SB as surgical treatments for the management of primary, non-complex rhegmatogenous retinal detachment (RRD). Data from 751 eyes that underwent PPV, SB or combined PPV/SB as a surgical treatment for primary non-complex RRD with at least 3 months of follow-up were analysed to determine rates of single surgery anatomic success (SSAS) and final anatomic success (FAS). Patients or the public were not involved in the design, conduct or reporting of this research. PPV accounted for 89.0% (n=668), PPV/SB for 6.8% (n=51) and SB for 4.2% (n=32) cases. Overall SSAS (91.2% PPV, 84.3% PPV/SB, 93.8% SB; p=0.267) and FAS (96.7% PPV, 94.1% PPV/SB and 100.0% SB; p=0.221) were reported for the three surgical groups. SSAS and FAS were similar for lens status, macular detachment status and the presence or absence of inferior retinal breaks for each of the PPV, PPV/SB and SB groups. In this large, single institution, retrospective case series, we report surgical outcomes for patients with primary non-complex RRD managed with PPV, SB or PPV/SB in the modern era of small-gauge vitrectomy. We demonstrate that primary PPV without adjunct SB provides excellent anatomic and visual outcomes irrespective of lens status, macular involvement or pathology location.