使用彩色多普勒成像检测无环扎的巩膜扣带术对球后血流动力学的影响

Effects of scleral buckling without encircling procedures on retrobulbar hemodynamics as measured by color doppler imaging

Objective: To study the effects of segmental scleral bucklingwithout encircling procedures on retrobulbar hemodynamic conditions using color Doppler imaging. Methods: In 65 consecutive eyes of 65 patients with unilateral rhegmatogenous retinal detachment repaired by scleral buckling, we prospectively measured the blood flow velocities in the ophthalmic artery, central retinal artery, and short posterior ciliary artery using color Doppler imaging before and 2, 12, and 24 weeks after surgery. Peak systolic velocity (PSV) and end diastolic velocity (EDV) (calculated in centimeters per second) were measured using color Doppler imaging. Results: The PSV and EDV in the ophthalmic artery were not changed significantly during follow-up. The PSV and EDV in the central retinal artery were reduced temporarily at 2 weeks after surgery, but at 12 weeks after surgery had returned to presurgery levels. The PSV and EDV in the short posterior ciliary artery on both sides continued to decrease postoperatively, and the reductions became statistically significant by 24weeks after surgery (buckled side: P=.001 for PSV and P=.002 for EDV; unbuckled side: P< .001 for PSV and P=.004 for EDV). The decreases of PSV and EDV in the short posterior ciliary artery on the buckled side were positively correlated with the subject’s age (R=0.40, P=.001 for PSV; and R=0.32, P=.008 for EDV). Conclusions: Scleral buckling procedures can cause subclinical disturbance of the choroidal circulation, even if encircling procedures are avoided. Aging is one of the risk factors for the disturbance.