Combined phacoemulsification and sutureless vitrectomy for treatment of rhegmatogenous retinal detachment

Ahmed Hosni Elhamid
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Abstract

Purpose: To report the success rate and possible complications of combined phacoemulsification and sutureless 23 gauge vitrectomy for treatment of rhegmatogenous retinal detachment (RRD). Patients and Methods: Thirty patients with RRD were included in the study. All patients were examined for the extent of detachment, number and location of retinal breaks, and degree of proliferative vitreoretinopathy (PVR). Combined phacoemulsification, intraocular lens implantation, 23 gauge vitrectomy, laser retinopexy, and 12% C3F8 injection were done for all patients. All eyes were followed for 3 months. The primary outcome measures were single operation success rate and change in best-corrected visual acuity (BCVA). Any intraoperative and postoperative complications were reported and analyzed. Results: The mean age of the patients was 43.9 ± 10.11 years; mean duration of detachment was 17.3 ± 5.53 days while mean preoperative BCVA measured by logarithm of the minimum angle of resolution (Log MAR) was 2.1 ± 0.71. Single operation success rate was achieved in 25 eyes (83.3%), 5 eyes (16.7%) showed failure of complete attachment after absorption of gas bubble. The mean postoperative BCVA was significantly better than the preoperative value (1.00, 1.1 after 6 weeks and 3 months, respectively, P < 0.01). The most common postoperative complications were reversible corneal edema that occurred in 11 eyes (36.6%), fibrinous uveitis in 8 eyes (26.6%) and posterior capsular opacification in 16 eyes (53.3%). Preoperatively, 1 eye (3.3%) had BCVA ≤1 (Log MAR) in comparison to 17 eyes (56.7%) and 18 eyes (60%) after 6 weeks and 3 months respectively. Conclusion: Combined phacoemulsification and sutureless vitrectomy with gas tamponade is safe and effective single surgical procedure for selected patients with RRD.
超声乳化术联合无缝线玻璃体切除术治疗孔源性视网膜脱离
目的:报道超声乳化联合无缝线23号玻璃体切除术治疗孔源性视网膜脱离(RRD)的成功率及可能的并发症。患者和方法:30例RRD患者纳入研究。检查所有患者的脱离程度、视网膜断裂的数量和位置以及增殖性玻璃体视网膜病变(PVR)的程度。所有患者均行联合超声乳化术、人工晶状体植入术、23号玻璃体切除术、激光视网膜固定术、12% C3F8注射。随访3个月。主要观察指标为单次手术成功率和最佳矫正视力(BCVA)变化。报告并分析术中及术后并发症。结果:患者平均年龄43.9±10.11岁;平均脱离时间为17.3±5.53天,以最小分辨角(Log MAR)的对数测量的平均术前BCVA为2.1±0.71。单次手术成功率25眼(83.3%),气泡吸收后完全附着失败5眼(16.7%)。术后BCVA均值明显优于术前(术后6周、3个月分别为1.00、1.1,P < 0.01)。术后最常见的并发症为可逆性角膜水肿11眼(36.6%),纤维性葡萄膜炎8眼(26.6%),后囊膜混浊16眼(53.3%)。术前BCVA≤1 (Log MAR) 1眼(3.3%),术后6周和3个月分别为17眼(56.7%)和18眼(60%)。结论:超声乳化术联合无缝合线玻璃体切除术加气体填塞是治疗RRD患者安全有效的单一手术方法。
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