laser retinopexy

激光视网膜固定术
  • 文章类型: Journal Article
    由于周边视网膜视图的像差,通过多焦点人工晶状体(IOL)进行激光视网膜固定术可能具有挑战性。这项研究调查了多焦点IOL与单焦点IOL对视网膜泪液激光视网膜固定术结果的影响。
    假晶状体眼(多焦点和单焦点IOL)因视网膜撕裂而接受了办公室激光视网膜固定术,至少随访三个月,进行回顾性分析。多焦点IOL的眼睛与单焦点IOL的对照以1:2的年龄比例相匹配,性别,number,和视网膜撕裂的位置。主要结果指标是并发症的发生率。
    我们在研究中纳入了168只眼。56只眼(51例)的多焦点IOL与112只眼(112例)的单焦点IOL相匹配。平均随访时间为26个月。两组的基线特征相似。在没有额外手术的情况下,激光视网膜固定术的成功率没有显着差异(91%与86%在3个月和79%74%在随访期间,在多焦点IOL和单焦点IOL组中,分别)。随后的RRD率没有观察到显著差异(多焦点,4%vs.monofocal,6%,P=0.716)或需要额外的激光视网膜固定术治疗新的眼泪(14%vs.15%;P=0.939)。玻璃体出血的手术率(0%vs.3%;P=0.537),ERM(2%与2%;P=0.553)和玻璃体漂浮物(5%vs.2%,P=0.422)无显著差异。视觉结果也相似。
    多焦点IOL似乎并未对视网膜撕裂的办公室激光视网膜固定术的结果产生负面影响。
    Performing laser retinopexy through multifocal intraocular lenses may be challenging due to aberrations of the peripheral retinal view. This study investigated the influence of multifocal versus monofocal intraocular lenses on outcomes of laser retinopexy for retinal tears.
    Pseudophakic eyes (multifocal and monofocal intraocular lenses) that underwent in-office laser retinopexy for retinal tears, with a minimum follow-up of 3 months, were retrospectively analyzed. Eyes with multifocal intraocular lenses were matched to controls with monofocal intraocular lenses in a 1:2 ratio for age, gender, number, and location of retinal tears. The main outcome measure was the rate of complications.
    We included 168 eyes in the study. Fifty-six eyes (51 patients) with multifocal intraocular lenses were matched with 112 eyes (112 patients) with monofocal intraocular lenses. The mean follow-up was 26 months. Baseline characteristics were similar between two groups. No significant differences were noted in the rate of successful laser retinopexy without additional procedures (91% vs. 86% at 3 months and 79% vs. 74% during follow-up, in the multifocal intraocular lens and monofocal intraocular lens group, respectively). No significant differences were observed in the rate of subsequent rhegmatogenous retinal detachment (multifocal, 4% vs. monofocal, 6%, p=.716) or need for additional laser retinopexy for new tears (14% vs. 15%; p=.939). The surgery rates for vitreous hemorrhage (0% vs. 3%; p=.537), epiretinal membrane (2% vs. 2%; p=.553), and vitreous floaters (5% vs. 2%, p=.422) were not significantly different. Visual outcomes were also similar.
    Multifocal intraocular lenses did not appear to negatively impact the outcomes of in-office laser retinopexy for retinal tears.
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  • 文章类型: Comparative Study
    目的:比较住院医师和专科医生行激光视网膜固定术治疗视网膜撕裂的结果,并确定与进展为视网膜脱离(RD)的风险相关的泪液特征。
    方法:对307只眼进行激光视网膜固定术,由表演医生分类,居民(217例)或专家(90例)。记录的参数包括数字,尺寸,和视网膜撕裂的位置,桥接血管的存在,玻璃体出血(VH),或视网膜下液(SRF),需要额外的激光,进展到RD,和手术。
    结果:居民组42.3%的病例和专科组35.5%的病例进行了额外的激光治疗(p=0.26)。居民组中有6.9%的病例进展为RD,专科组中有5.5%的病例进展为RD(p=0.66)。VH和SRF的存在与进展为RD的风险增加相关(分别为p<0.0001和0.003)。由专家治疗的SRF病例比例更高(p=0.006)。
    结论:居民可以安全有效地进行激光视网膜固定术,没有比专家执行的程序更糟糕的结果。可能需要高速率的额外激光来实现RD预防,高风险病例可以在演示时识别,然后转交给专家。
    OBJECTIVE: To compare the outcomes of laser retinopexy for the treatment of retinal tears between residents and specialists, and to identify tear characteristics associated with the risk of progression to retinal detachment (RD).
    METHODS: A retrospective review of 307 eyes treated by laser retinopexy, categorized by the performing physician, either a resident (217 cases) or a specialist (90 cases). Recorded parameters included the number, size, and location of the retinal tears, the presence of bridging vessels, vitreous hemorrhage (VH), or subretinal fluid (SRF), the need for additional laser, progression to RD, and surgery.
    RESULTS: Additional laser was performed in 42.3% of cases in the resident group and 35.5% in the specialist group (p = 0.26). Progression to RD occurred in 6.9% of cases in the resident group and 5.5% in the specialist group (p = 0.66). The presence of VH and SRF were associated with an increased risk of progression to RD (p < 0.0001 and 0.003, respectively). A higher proportion of cases with SRF were treated by specialists (p = 0.006).
    CONCLUSIONS: Laser retinopexy is safely and effectively performed by residents, with no worse outcomes than procedures performed by specialists. A high rate of additional laser may be needed to achieve RD prophylaxis, and higher-risk cases can be identified at presentation and then referred to specialists.
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  • 文章类型: Comparative Study
    The purpose of this study is to compare the efficacy of intraoperative 360° and localized laser retinopexy in 23-gauge pars plana vitrectomy (PPV) for rhegmatogenous retinal detachments (RRD) with undetected retinal breaks intraoperatively. This is a retrospective, comparative, interventional study. Medical records of 48 consecutive eyes with RRD of intraoperative undetected retinal breaks were reviewed. Nineteen patients (group I) received 360° laser retinopexy in PPV, while the remaining 29 patients (group II) underwent localized laser retinopexy. In group I, a triple row of confluent medium-white laser burns were placed posterior to the ora serrata. Anatomical and visual outcomes of the two groups were compared. The mean follow-up period was 13.46 ± 3.02 months. No significant difference was identified in baseline characteristics. A single-operation reattachment rate of 89.47% was achieved in group I, which was significantly higher than that of group II (55.17%, p = 0.01), and this trend was not weakened after adjustment for the confounding factor (odds ratio 0.15, p = 0.03). Moreover, greater improvement of postoperative best-corrected visual acuity was observed in group I. Significant complications sufficient to require further operation included proliferative vitreoretinopathy in 2 (4.17%) eyes and epiretinal membrane in 4 (8.33%) eyes. Three hundred sixty-degree laser retinopexy was associated with better anatomic and visual outcomes in RRD patients with unseen breaks intraoperatively, when compared with localized laser retinopexy in PPV.
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