Abstract：
This study aimed to evaluate the usefulness of an encircling scleral buckling procedure to manage severe hypotony secondary to proliferative vitreoretinopathy (PVR)-induced retinal detachment. This retrospective study included six eyes of six patients (five women and one man) with hypotony (intraocular pressure [IOP] ≤ 6 mmHg) after multiple reattachment surgeries for PVR-induced retinal detachment. In patients with failure of hypotony resolution after conservative treatment (dexamethasone drops five times daily), 360° scleral buckling was performed under periocular anesthesia. The light perception was evaluated immediately postoperatively. The anatomic parameters were evaluated pre- and postoperatively observed on anterior segment swept-source optical coherence tomography. Ciliary body detachment (CBD) secondary to advanced cyclitic membranes associated with PVR grades C and D was detected in all eyes with hypotony. The mean IOP increased in all eyes (4.83 mmHg preoperatively vs. 10.17 mmHg postoperatively, p = 0.006), with subsequent improvement in best-corrected visual acuity (1.91 logMAR preoperatively vs. 1.50 logMAR postoperatively, p = 0.034). However, no eye showed any significant changes in CBD postoperatively. Scleral buckling surgery might be useful to increase IOP in eyes with persistent severe hypotonia secondary to PVR-induced CBD. Further studies are needed to improve outcomes in eyes with severe PVR-induced retinal detachment.
摘要：
这项研究旨在评估环绕巩膜扣带术治疗增生性玻璃体视网膜病变（PVR）引起的视网膜脱离继发的严重低眼压的有效性。这项回顾性研究包括6例患者（5例女性和1例男性）的六只眼睛，这些患者在多次重新附着手术治疗PVR引起的视网膜脱离后出现低眼压（眼内压[IOP]≤6mmHg）。对于保守治疗后低眼压消退失败的患者（地塞米松每天滴注五次），在眼周麻醉下进行360°巩膜扣带术。术后立即评估光感知。在眼前节扫描源光学相干断层扫描上术前和术后观察到的解剖参数。在所有低眼压的眼中都检测到与PVRC级和D级相关的高级环化膜继发的睫状体脱离（CBD）。所有眼的平均IOP均增加（术前4.83mmHg与术后10.17mmHg，p=0.006),随后最佳矫正视力的改善(术前logMAR与1.50logMAR术后，p=0.034)。然而,术后无眼部显示CBD有任何显著变化.巩膜扣带术可能有助于增加因PVR引起的CBD引起的持续性严重张力减退的眼睛的IOP。需要进一步的研究来改善患有严重PVR诱导的视网膜脱离的眼的预后。
