Scleral buckling versus primary vitrectomy in the management of retinal detachment associated with mild vitreous hemorrhage
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Tarih
2014
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmanın amacı hafif vitreus hemorajisi bulunan regmatojen retina dekolmanı olgularında skleral çökertme (SÇ) ile pars planvitrektominin (PPV) anatomik ve görsel iyileşmedeki cerrahi etkinliklerinin karşılaştırılması. Gereç ve Yöntem: Çalışmaya hafif derecede vitreus hemorajisi ile komplike olmuş regmatojen retina dekolmanı olan ve bu nedenldaha önce operasyon geçirmemiş 78 hastanın 78 gözü dahil edildi (38 göz SÇ, 40 göz PPV). Tüm hastalar postoperatif altı aydan dahuzun sürelerde izlendi. Cerrahi sonuç ve komplikasyon oranları retrospektif olarak karşılaştırıldı. İstatistiksel analiz için Mann-WhitneU ve Ki-kare testleri kullanıldı. Bulgular: İlk cerrahi sonrasında SÇ grubunda %78,9 (30/38), PPV grubunda %95 (38/40) oranında retinal yatışıklık sağlandıGruplar arasındaki farklılık istatistiksel olarak anlamlıydı (p=0,035). Skleral Çökertme grubundaki dört gözde retinal yırtığıgörüntülenememesi, iki gözde uygunsuz yerleşimli çökertmenin bulunması ve iki gözde yırtığın yetersiz kapanması, PPV grubunda isiki gözde asıl yırtıkların tekrar açılması cerrahi başarısızlık nedenleriydi. Postoperatif üçüncü ve altıncı aylardaki görsel gelişim PPV grubunda SÇ grubuna göre anlamlı derecede daha iyi bulundu (p<0,001 ve p=0,026). Peroperatif ve postoperatif komplikasyonlar; SÇ grubunda, subretinal hemoraji (%5,2), B veya daha ileri derecede proliferatif vitreoretinopati (PVR) (%10,5), makular pucker (%7,8)postoperatif katarakt (%13), PPV grubunda ise iyatrojenik yırtıklar (%10), lens hasarı (%5), B veya daha ileri derecede PVR (%5)makular pucker (%5) ve postoperatif katarakt (%35) oranlarında görüldü. Sonuç: İyatrojenik retinal yırtıklar ve postoperati ve katarakt gelişimi PPV olgularındaki en belirgin sorunlar olmasına karşın periferavitreoretinal çekintilerin çözülebilmesi ve vitreus hemorajisinin temizlenebilmesi nedeniyle hafif derecede hemorajinin eşlik ettiğregmatojen retina dekolmanı olgularında PPV anatomik ve fonksiyonel olarak daha iyi sonuçlar göstermektedir. (Turk J Ophthalmo2014; 44: 92-7)
Objectives: The aim of this study was to compare the surgical impact of scleral buckling (SB) and pars plana vitrectomy (PPV) on the anatomic results and visual recovery in cases of rhegmatogenous retinal detachment with mild vitreous hemorrhage. Materials and Methods: In this study, we included 78 eyes of 78 phakic patients who underwent primary surgery for rhegmatogenous retinal detachment complicated by mild vitreous hemorrhage (38 eyes by SB,40 eyes by PPV);all patients had been followed for longer than 6 months after surgery. The surgical outcome and the rate of complications were retrospectively compared. Mann-Whitney U-test and chi-square test were used for the statistical analysis. Results: The reattachment rate after the first surgery was 78.9% (30/38) in the SB group and 95% (38/40) in the PPV group. The difference between the groups was statistically significant (p=0.035). Unseen retinal breaks in 4 eyes, malpositioned buckle in 2 eyes and insufficient closure of the break in 2 eyes of SB cases, as well as reopening of the original break in 2 eyes of PPV cases were the causes of failure. Visual improvement in the PPV group was significantly better than in the SB group in the third and sixth postoperative months (p<0.001 and p=0.026, respectively). Peroperative and postoperative complications were as follows: in the SB group-subretinal hemorrhage (5.2%), PVR of grade B or worse (10.5%), macular pucker (7.8%), and postoperative cataract (13%); in the PPV group- iatrogenic breaks (10%), lens damage (5%), PVR of grade B or worse (5%),macular pucker (5%), and postoperative cataract (35%). Conclusion: Even though the high incidence of peroperative complications such as iatrogenic breaks or postoperative complications such as cataract formation was the major drawback, the results indicate that PPV performed to alleviate peripheral vitreoretinal tractions and clear vitreous hemorrhage offers better anatomic and functional results than SB in the management of rhegmatogenous retinal detachment associated with mild vitreous hemorrhage. (Turk J Ophthalmol 2014; 44: 92-7)
Objectives: The aim of this study was to compare the surgical impact of scleral buckling (SB) and pars plana vitrectomy (PPV) on the anatomic results and visual recovery in cases of rhegmatogenous retinal detachment with mild vitreous hemorrhage. Materials and Methods: In this study, we included 78 eyes of 78 phakic patients who underwent primary surgery for rhegmatogenous retinal detachment complicated by mild vitreous hemorrhage (38 eyes by SB,40 eyes by PPV);all patients had been followed for longer than 6 months after surgery. The surgical outcome and the rate of complications were retrospectively compared. Mann-Whitney U-test and chi-square test were used for the statistical analysis. Results: The reattachment rate after the first surgery was 78.9% (30/38) in the SB group and 95% (38/40) in the PPV group. The difference between the groups was statistically significant (p=0.035). Unseen retinal breaks in 4 eyes, malpositioned buckle in 2 eyes and insufficient closure of the break in 2 eyes of SB cases, as well as reopening of the original break in 2 eyes of PPV cases were the causes of failure. Visual improvement in the PPV group was significantly better than in the SB group in the third and sixth postoperative months (p<0.001 and p=0.026, respectively). Peroperative and postoperative complications were as follows: in the SB group-subretinal hemorrhage (5.2%), PVR of grade B or worse (10.5%), macular pucker (7.8%), and postoperative cataract (13%); in the PPV group- iatrogenic breaks (10%), lens damage (5%), PVR of grade B or worse (5%),macular pucker (5%), and postoperative cataract (35%). Conclusion: Even though the high incidence of peroperative complications such as iatrogenic breaks or postoperative complications such as cataract formation was the major drawback, the results indicate that PPV performed to alleviate peripheral vitreoretinal tractions and clear vitreous hemorrhage offers better anatomic and functional results than SB in the management of rhegmatogenous retinal detachment associated with mild vitreous hemorrhage. (Turk J Ophthalmol 2014; 44: 92-7)
Açıklama
Anahtar Kelimeler
Göz Hastalıkları
Kaynak
Türk Oftalmoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
44
Sayı
2
