玻璃体切割和空气填塞治疗非下孔性视网膜脱离

Q4 Medicine

中华眼底病杂志 Pub Date : 2019-11-25 DOI:10.3760/CMA.J.ISSN.1005-1015.2019.06.011

Ye Zhang, Fang Chen, Jun Zhu, Wei Du, Chunlan Gan, Jun Tong, Xi Chen, Zhenggao Xie

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引用次数: 0

摘要

目的观察23G玻璃体切割联合空气填塞治疗非下孔源性视网膜脱离(RRD)的疗效。方法前瞻性病例系列研究。2017年8月至2018年4月，扬州大学附属苏北人民医院眼科连续39例RRD患者(39只眼)加入本研究。男性20只(20眼)，女性19只(19眼)，右眼23只，左眼16只，平均年龄55±11岁。有晶状体30眼，无晶状体或人工晶状体9眼。视网膜撕裂1眼21眼，2眼14眼，大于或等于3眼4眼。所有患者均行23G PPV切除视网膜前增生性膜和玻璃体皮质，裂口周围3-5行光凝，过滤空气填塞。随访2个多月。观察视网膜再植、视力及并发症。采用Pearson相关分析分析BCVA与病程的相关性。采用卡方检验比较术前视网膜再附着率与不同临床因素的差异。结果术后2个月，35眼视网膜复植，复植率89.8%。术后2 ~ 3周，4只眼再次脱离，均行硅油填塞。一只眼继发于黄斑前膜。PPV前后的logMAR BCVA分别为1.15±0.78和0.41±0.31 (t=6.589, P=0.0001)。相关分析结果显示，术后BCVA与术前BCVA呈正相关(r=0.544, P=0.001)。30只装有晶状体的眼睛中有12只患有白内障。再附着率随断裂次数的变化而变化(χ2=9.181, P=0.010)。结论PPV联合空气填塞是治疗非劣性RRD的最佳方法，成功率高，安全性好。关键词:视网膜穿孔;玻璃体切除术;空气

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Management of non-inferior rhegmatognous retinal detachment with vitrectomy and air tamponade

Objective To observe the outcomes of 23G pars plana vitrectomy (PPV) and air tamponade for non-inferior rhegmatognous retinal detachment (RRD). Methods A prospective case series study. From August 2017 to April 2018, 39 consecutive RRD patients (39 eyes) in Department of Ophthalmology of Subei People’s Hospital Affiliated to Yangzhou University were enrolled in this study. There were 20 males(20 eyes) and 19 females (19 eyes), 23 right eyes and 16 left eyes, with the mean age of 55±11 years. There were 30 eyes with lens and 9 eyes without lens or IOL. There were 21, 14 and 4 eyes with 1, 2 and equal or greater than 3 retinal tear respectively. All patients underwent 23G PPV which performed preretinal proliferative membranes and vitreous cortex removal, photocoagulation around the breaks with 3-5 rows, and filtered air tamponade. The follow-up was more than 2 months. The retinal reattachment, visual acuity and complications were observed. Pearson correlation analysis was used to analyze the correlation between BCVA and disease course. Chi-square test was performed for comparison among retinal reattachment rate and different clinical factors before operation. Results At 2 months after the PPV, 35 eyes' retina reattached, the rate of reattachment was 89.8%. In 2-3 weeks, 4 eyes were re-detached, all of them performed silicone oil tamponade. One eye was secondary to pre-macular membrane. The logMAR BCVA before and after PPV were 1.15±0.78 and 0.41±0.31, respectively (t=6.589, P=0.0001). Correlation analysis results showed that BCVA after surgery was positively correlated with BCVA before surgery(r=0.544, P=0.001). Twelve of 30 eyes with crystalline lens suffered cataract. The rate of reattachment vary in the number of the breaks (χ2=9.181, P=0.010). Conclusion PPV with air tamponade may be an optimal treatment of non-inferior RRD with better success rate and security. Key words: Retinal perforations; Vitrectomy; Air

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来源期刊

中华眼底病杂志 Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

5383

期刊介绍： Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).