■介绍一种环绕激光预防的新技术(Orasecunda环扎Stickler综合征,OSC/SS)预防Stickler综合征眼的孔源性视网膜脱离(RRD)。
■分别在50岁和18岁时进行第一眼RRD后,一位53岁的父亲和他22岁的儿子患有2型SS(STL2),给予知情同意并接受了OSC/SS预防,在每个同伴的眼睛里表演。一名26岁的STL2女儿随后遭受了第一次眼睛视网膜脱离,并同样选择了其他眼睛OSC/SS预防。第二个儿子,28岁的STL2患者,双眼选择OSC/SS预防。
■三个经过OSC/SS治疗的同胞眼睛已经过去了12年,11年,8年没有RRD。已知STL1和较不常见的STL2眼睛具有相似的RRD率,在没有预防的情况下,80%的STL1同眼在中位4年出现RRD。此外,六个已知的STL2家庭成员中有五个(83%)患有RRD,只有具有双侧OSC/SS的STL2儿子保持双侧连接。所有五只OSC/SS治疗的眼睛(预防后平均8.7年)保留了20/20至20/30的术前视力,无症状的子午场在每只眼睛减少到50度。相比之下,在演示前遭受RRD的三只眼睛中,视力范围为20/125至8/200,平均子午线视野为29度。
■在Stickler眼中改良的环绕网格激光(OSC)以包围锯齿缘并向后延伸到涡旋静脉壶腹之间(OSC/SS)是一种合理的RRD预防选择,可以为STL1和STL2患者提供替代治疗或预防效果较差的方法。由于稀有和严重,安全性和有效性的最终证明可能不是来自随机试验,但是从一个非随机的,prospective,此类个人努力的队列比较研究。
UNASSIGNED: To introduce a novel technique of encircling laser prophylaxis (ora secunda cerclage Stickler syndrome, OSC/
SS) to prevent rhegmatogenous retinal detachment (RRD) in Stickler syndrome eyes.
UNASSIGNED: After first eye RRD at age 50 and at age 18, respectively, a 53-year-old father and his 22-year-old son with type 2
SS (STL2) gave informed consent and underwent OSC/
SS prophylaxis, performed in each fellow eye. A 26-year-old STL2 daughter then suffered first eye retinal detachment and similarly chose fellow eye OSC/SS prophylaxis. A second son, 28 years of age with STL2, chose OSC/
SS prophylaxis in both eyes.
UNASSIGNED: The three OSC/
SS treated fellow eyes have gone 12 years, 11 years, and 8 years without RRD. STL1 and less common STL2 eyes are known to have a similar rate of RRD, and 80% of STL1 fellow eyes develop RRD at a median of 4 years in the absence of prophylaxis. Moreover, five of six (83%) known STL2 family members suffered RRD, only the STL2 son with bilateral OSC/SS remaining bilaterally attached. All five OSC/SS treated eyes (average 8.7 years post-prophylaxis) retained preoperative visual acuity of 20/20 to 20/30, with an average, asymptomatic reduction of meridional field in each eye to 50 degrees. In contrast, in the three eyes having suffered RRD prior to presentation, visual acuity ranged from 20/125 to 8/200 and average meridional field was 29 degrees.
UNASSIGNED: Encircling grid laser (OSC) modified in Stickler eyes to encompass the ora serrata and extend posteriorly to and between the vortex vein ampullae (OSC/SS) is a reasonable RRD prophylaxis option to offer STL1 and STL2 patients as an alternative to no treatment or less effective prophylaxis. Because of rarity and severity, the ultimate proof of safety and efficacy will likely come not from randomized trials, but from a non-randomized, prospective, cohort comparison study of such individual efforts.