改良巩膜扣带术与扁平部玻璃体切除术治疗孔源性视网膜脱离的疗效比较

Comparison of modified scleral buckling and pars plan vitrectomy in treatment of rhegmatogenous retinal detachment

目的 比较改良巩膜扣带术(RSB)与扁平部玻璃体切除术(PPV)治疗孔源性视网膜脱离(RRD)的疗效。方法 选取2019年1月至2021年5月诊治的RRD患者110例,分为RSB组和PPV组各55例。比较两组术后1年内疗效、最佳矫正视力(BCVA)、眼压(IOP)、黄斑脉络膜厚度(SCT)、轴向长度(AL)及术后并发症。结果 两组初次手术解剖成功率、最终解剖成功率、术后BCVA、IOP及并发症比较,差异无统计学意义(P>0.05)。随访12个月时,PPV组白内障进展率高于RSB组(P<0.05)。术后3个月,RSB组SCT高于PPV组(P<0.05);两组术后6个月、12个月比较,差异无统计学意义(P>0.05)。术后1个月RSB组AL高于PPV组(P<0.05);术后3个月、6个月、12个月两组比较,差异无统计学意义(P>0.05)。结论 RSB和PPV对RRD患者具有相似的疗效,RSB术后白内障进展情况低于PPV,外科治疗RRD时建议优先考虑RSB技术。

【Objective】 To compare the curative effect of modified scleral buckling(RSB) and pars plan vitrectomy(PPV) in the treatment of rhegmatogenous retinal detachment(RRD). 【Methods】 A total of 110 RRD patients diagnosed and treated from 2019 to 2021 were selected and divided into RSB group and PPV group with 55 cases each. The efficacy, best corrected visual acuity(BCVA), intraocular pressure(IOP), macular choroid thickness(SCT), axial length(AL) and postoperative complications were compared between the two groups within 1 year after surgery. 【Results】 There were no statistically significant differences in the initial anatomy success rate, final anatomy success rate, postoperative BCVA, IOP and complications between the two groups(P>0.05). At 12 months of follow-up, the cataract progression rate in the PPV group was higher than that in the RSB group, and the difference was statistically significant(P<0.05). At 3 months after operation, SCT in RSB group was higher than that in PPV group(P<0.05). There was no significant difference between the two groups at 6 and 12 months after operation(P>0.05). One month after operation, AL in RSB group was higher than that in PPV group(P<0.05). There was no significant difference between the two groups at 3, 6 and 12 months after operation(P>0.05). 【Conclusion】 RSB and PPV have similar curative effects on RRD patients.The progression of cataract after RSB is lower than that of PPV. It is recommended to give priority to RSB technique when choosing surgical treatment for RRD.