实习医师施行巩膜扣带术治疗视网膜脱离的效果

Outcomes of scleral buckle technique performed by trainee doctors in retinal detachment

目的:评估实习医师施行巩膜扣带术治疗视网膜脱离的效果。方法:非比较回顾性病例。评估2017-07/2018-02在印度三级护理中心接受巩膜扣带术修复的孔源性视网膜脱离(RRD)患者的人口学、临床特征和效果。对所有患者的记录进行了筛查。统计分析采用Fisher确切干预,Mann-Whitney检验和Logistic回归分析。结果:共41例患者,其中男32例(78%),女9例(22%)。在我们的研究中,Ⅰ期解剖成功率为95%,视力明显提高。2例患者术后出现并发症—眼压升高、新裂孔以及再次脱离,经玻璃体切除术(PPV)内填塞及激光成功治疗。结论:研究表明,通过指导,实习医生对RRD患者行巩膜扣带术无论从术后解剖成功率、视力还是并发症发生率来看,均能获得较高的成功率。因此,尽管现有的治疗方法多种多样,但对于实习医生来说,巩膜扣带术是一种可接受的治疗RRD的主要方法。

AIM:To evaluate the outcomes of patients operated for retinal detachment by scleral buckle technique done by trainee doctors pursuing postgraduate course in ophthalmology.METHODS:This study was a non-comparative retrospective case series to evaluate the demography,clinical features and outcomes of patients underwent rhegmatogenous retinal detachment(RRD)repaired by scleral buckle technique from July 2017 to February 2018 at a tertiary care center in India.Records of all these patients were screened.Statistical analyses were performed and using Fisher’s exact test,Mann-Whitney test and Nominal Logistic regression.RESULTS:Totally of 41 patients were included out of which,32(78%)were males and 9(22%)were females.In our study primary anatomical success rate was 95%,with significant visual gain.Postoperative complications were raised intraocular pressure(n=2),new breaks(n=2)and re-detachment in 2 patients which was successfully managed by pars plana vitrectomy(PPV)with internal tamponade and laser.CONCLUSION:The study showed that scleral buckle surgeries done by trainee doctors under supervision can achieve a high success rate in patients of RRD both in terms of postoperative anatomical success,visual acuity and complication rates.Thus,scleral buckle surgery can be an acceptable primary procedure for trainee doctors for management of RRD in selected cases despite the various treatment options now available.