Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment

裂孔性視網膜剝離之氣體充填視網膜固定手術治療

蔡景耀(Ching-Yao Tsai) ； 張庭嘉(Ting-Jia Chang) ； 周碧瑟(Pesus Chou) ； 劉秀雯(Shiow-Wen Liou)

《中華民國眼科醫學會雜誌》 46卷1期 (2007/03) Pp. 8-12

https://doi.org/10.30048/ACTASOS.200703.0002

摘要

目的：本篇研究之目的，為探討對於初於性裂孔性視網膜剝離(primary rhegmatogenous retinal detachment, RRD)之患者以氣體充填視網膜固定術(pneumatic retinopexy, PR)為首選治療之術後結果，並評估其復發視網膜剝離之頻率。
設計：以區域級教學醫院為基礎之回顧性、無配對比較型病例系列研究。
方法：我們收集之所有患眼皆為上部裂孔性視網膜剝離，其侵犯的區間坐落介於八點鐘至四點鐘方位之間，且範圍延伸未超過兩個鐘點。若為長期剝離狀態、有增殖性玻璃體視網膜病變之跡證、裂孔位於眼底下方、或是術後無法配合俯臥姿之病患，我們皆將其排除於收集範圍之內。單一手術成功定義為於施行完畢氣體充填視網膜固定術之後視網膜即回貼；而最終治療成功之定義則為單一手術成功或是氣體充填視網膜固定術合併其他手術步驟之後視網膜成功回貼。
結果：於2003年一月至2005年八月總共有5隻上部裂孔性視網膜剝離之患眼接受氣體充填視網膜固定術並收集進本研究中（占8.3%），其中包括兩位女性(40%)與三位男性(60%)。平均年齡為44.2±18.1歲。每一隻患眼皆已接受六個月以上之追蹤，平均為90.2±39.0周。單一手術成功率為60%，而在追蹤觀察之後，其最終治療成功率為100%。在追蹤過程中我們並未發現到有任何不良影響或是產生主要併發症。
結論：本研究發現，若能謹慎選取合適的病患，氣體充填視網膜固定術為治療上部裂孔性視網膜剝離之安全有效的方法。

並列摘要

Purpose: The purpose of this study is to describe the surgical outcomes of treating primary rhegmatogenous retinal detachment (RRD) with pneumatic retinopexy as treatment of choice, and to assess frequency of postoperative redetachment.
Setting: We conducted a hospital-based retrospective, noncomparative case series study at the Department of Ophthalmology, Zhongxing Branch, Taipei City Hospital, Taiwan.
Methods: We included all cases of RRD in which breaks were superior (between clock hours 8 and 4), and not exceeding 2 clock hours in extent. Longstanding RRD, evidence of proliferative vitreoretinopathy (PVR) or inferior breaks, and cases unable to keep appropriate postoperative posture were excluded. Single-operation success was defined as successful retinal attachment following the first attempt at pneumatic retinopexy (PR). Final success was defined as successful attachment, either after single-operation success or after an additional operation.
Results: Of 60 cases of retinal detachment, 5 cases (8.3%) of superior RRD undergoing PR were enrolled between January 2003 and August 2005. Two subjects were female (40%) and 3 were male (60%). The mean age was 44.2±18.1 years. Every case was followed up for 6 months or more. The mean follow-up interval was 90.2 39.0 weeks. The single-operation success rate was 60%, and the final success rate was 100% during our follow up. There were no adverse effects or major postoperative complications noted throughout our follow-up period.
Conclusions: In our study, pneumatic retinopexy was found to be a useful and safe procedure for superior rhegmatogenous retinal detachment surgery in carefully selected cases.

並列關鍵字

pneumatic retinopexy ； rhegmatogenous retina detachment ； scleral buckling surgery