由于视网膜脱落而导致的初级视网膜切除术后的斑点变化,并由增殖性视网膜病变复杂化
Piergiacomo Grassi1, David Charteris2
1School of Medical Sciences, the University of Manchester, Manchester, UK.
Clinical & experimental optometry
|September 7, 2023
概括
针对严重视网膜脱落的初级视网膜切除术的成功率有限,在两次手术后,解剖学成功率约为60%. 视觉结果通常很差,黄斑状况显著影响功能结果.
科学领域:
- 眼科医生 眼科 眼科
- 视网膜外科手术 视网膜外科手术
- 玻璃关节疾病 玻璃关节疾病
背景情况:
- 主要视网膜切除术,这是一种很少在没有先前视网膜切除术的情况下在眼睛中进行的手术,正在研究复杂的视网膜脱落.
- 由先进的增殖性视视网膜病变 (PVR) 复杂化的形视网膜脱落 (RRD) 带来了重大的外科手术挑战.
研究的目的:
- 评估RRD和PVR等级C或D的眼睛中初级视网膜切除术的解剖和功能结果.
- 评估原发性视网膜切除术患者的黄斑结构变化及其与视力敏度的相关性.
主要方法:
- 一项回顾性多中心队列研究包括35只眼睛,在2014年至2021年期间,为RRD与PVR C或D进行初级视网膜切除术.
- 收集的数据包括解剖学成功率,手术前后最佳校正视敏度 (BCVA),以及通过OCT的黄斑状况.
主要成果:
- 一次视网膜切除术后的解剖学成功率为48.5%,两次视网膜切除术后为60%. 术后BCVA平均值为1.85 ± 0.62 logMAR,与基线没有显著改善.
- 只有17%的病例达到最终BCVA≥6/60. 手术后的斑点OCT显示了10%的正常解剖,60%的排泄性斑点病变,20%的伸缩性斑点病变,10%的缩.
- 最终的BCVA在正常黄斑解剖的眼睛显著好于与排泄性黄斑病变或黄斑缩的眼睛相比.
结论:
- 初级视网膜切除术可以考虑RRD与先进的PVR,但结果通常低于非初级视网膜切除术.
- 功能结果受到术后黄斑状况的强烈影响,正常的黄斑解剖是积极的预后因素.
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