关键词: 视网膜脱离/外科学, 人工晶状体眼, 巩膜扣带术, 玻璃体切除术

Abstract: Objective To observe and compare the anatomical and functional outcome of scleral buckling (SB) and pars plana vitrectomy (PPV) to treat the rhegmatogenous retinal detachment (RRD) with proliferative vitreoretinopathy (PVR) grade C1 below in the intraocular lens (IOL) eyes. Design Retrospective case series. Participants 156 patients (156 eyes) with IOL diagnosed as RRD at the south district of Beijing Tongren Hospital were enrolled. Methods Review the patient records. According to the method of surgery, all patients included were divided into SB group (44 eyes) and PPV group (112 eyes). The general characteristics, left/right eyes, retinal detachment duration, number and shape of retinal holes, and the stage of PVR were recorded for both groups. The rate of retinal reattachment (after primary and final surgery), best corrected visual acuity (BCVA), and secondary surgery were observed and compared between the two groups at 6 months after surgery. We also analyzed the reasons for the second surgery. Main Outcome Measures The rate of retinal reattachment, BCVA, and secondary surgery at 6 months after primary surgery. Results There was no difference in gender, left/ right eyes, retinal detachment duration, number and shape of retinal holes, and the stage of (PVR) between SB group and PPV group (all P>0.05). The rate of retina reattachment after the initial surgery was 77.3% (34/44) in SB group, and 92.9% (104/112) in PPV group (χ2=7.52，P=0.006). The secondary PPV was underwent for the patients without retinal reattachment, and finally, all of them achieved anatomical success. In the cases with unattached retina after the primary surgery in SB group, except for one new retinal hole, the rest retinal holes were all located on the encircling ridge. The absence of retina reattachment was associated with the progression of PVR. In the PPV group, the unattached retina after the primary surgery was also associated with postoperative PVR. The BCVA (LogMAR) before and after surgery in the SB group were 1.1 (0.70, 1.80) and 0.75 (0.50, 1.00), respectively (P=0.003). And in PPV group, the BCVA (LogMAR) before and after surgery were 1.9 (1.53, 1.90) and 0.7 (0.50, 1.00), respectively (P<0.001). There was no statistically significant difference in postoperative BCVA between these two groups (P=0.35). Conclusion For RRD with PVR less severe than grade C1 in IOL eyes, postoperative PVR is an important factor that affects the success rate of surgery. Although SB can achieve good surgical efficiency, PPV is superior to SB surgery in terms of retinal reattachment rate. (Ophthalmol CHN, 2023, 32: 192-196)

Key words: retinal detachment/sugery, intraocular lens, scleral buckling, pars plana vitrectomy