Morfološki i funkcionalni ishod klasične hirurške metode u odnosu na pars plana vitrektomiju kod bolesnika sa ablacijom retine

  • Miroslav Stamenković Eye Clinic, Clinical Center Zvezdara, Belgrade, Serbia
  • Ivan Stefanović Faculty of Medicine, University of Belgrade, Serbia
  • Ivan Senćanić Eye Clinic, Clinical Center Zvezdara, Belgrade, Serbia
  • Vesna Jakšić Eye Clinic, Clinical Center Zvezdara, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia
  • Milka Mavija University Eye Clinic, Banjaluka, Republic of Srpska, Bosnia and Herzegovina
  • Siniša Babović Eye Clinic, Clinical Center Zvezdara, Belgrade, Serbia
DOI: https://doi.org/10.2298/3143
Ključne reči: retinal detachment||, ||retina, ablacija, scleral buckling||, ||vitrektomija, vitrectomy||, ||serklaž vitrektomija, visual acuty||, ||vid, oštrina, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod/Cilj. Najčešće hirurške metode rešavanja ablacije retine su klasična metoda sa serklažom i pars plana vitrektomija (PPV). Cilj ovog rada bio je da se utvrdi koja od navedenih hirurških tehnika ima bolje morfološke (u smislu naleganja retine) i funkcionalne rezultate (vidna oštrina). Metode. Ova retrospektivna studija sprovedena je tokom dve godine na ukupno 98 očiju kod 97 bolesnika sa regmatogenom ablacijom retine koji su operisani ili klasičnom metodom sa serklažom (68 očiju) ili PPV metodom (30 očiju). Rezultati. U grupi bolesnika operisanih klasičnom metodom, retina je nalegla kod 52 (76,5%) oka vs 30 (100%) oka operisana PPV (p < 0,05).  Postoperativna VA (u logMAR) bila je značajno bolja kod obe grupe u odnosu na preoperativne vrednosti: kod klasične metode preoperativna  VA iznosila je1,89 ± 1,04 vs postoperativno 0,98 ± 0,70. U PPV grupi, preoperativna VA iznosila je 2,56 ± 0,67 vs 1.31 ± 0.74 postoperativno  (p = 0.001). Zaključak. PPV kod nekomplikovanih regmatogenih ablacija retine daje bolje anatomske i morfološke rezultate nego klasična operacija sa serklažom. Vidna oštrina je postoperativno bila bolja u obe grupe, ali je srednja vrednost vidne oštrine bila bolja u grupi operisanoj klasičnom metodom, verovatno zato što je PPV grupa imala lošiju inicijalnu vidnu oštrinu.

Reference

Birgul T, Vidic B, El-Shabrawi Y. Intrusion of an encircling buckle after retinal detachment surgery. Am J Ophthalmol 2003; 136(5): 942−4.

Kumar N, Zeldovich A, Chang A. Scleral buckle intrusion. Clin Experiment Ophthalmol 2004; 32(2): 228−9.

Kawana K, Okamoto F, Hiraoka T, Oshika T. Ciliary body edema after sclera buckling surgery in rhegmatogenous retinal de-tachment. Ophthalmology 2006; 113(1): 36−41.

OshimaY, Yamanishi S, Sawa M, Motokura M, Harino S, Emil K. Two-year follow-up study comparing primary vitrectomy with scleral buckling for macula-off rhegmatogenous retinal de-tachment. Jpn J Ophthalmol 2000; 44(5): 538−49.

Miki D, Hida T, Hotta K, Shinoda K, Hirakata A. Comparisson of sclera buckling and viterctomy for retinal detachment re-sulting from flap tears in superior quadrants. Jpn J Ophthalmol 2001; 45(2): 187−91.

Heimann H, Zou X, Jandeck C, Kellner U, Bechrakis NE, Kreusel KM, et al. Primary vitrectomy for rhegmatogenous retinal de-tachment: an analysis of 512 cases. Graefes Arch Clin Exp Ophthalmol 2006; 244(1): 69−78.

Sharma YR, Karunanithi S, Azad RV, Vohra R, Pal N, Singh V, et al. Functional and anatomic outcome of sclera buckling versus primary vitrectomy in pseudophakic retinal detachment. Acta Ophthalmol Scand 2005; 83(3): 293−7.

Tewari HK, Kedar S, Kumar A, Garg SP, Verma LK. Comparison of sceral buckling with combined sclera buckling and pars plana vitrectomy in the management of rhegmatogenous retinal detachment with unseen retinal breaks. Clin Experiment Ophthalmol 2003; 31(5): 403–7.

Lincoff H, Kreissing I. Ectraocular repeat surgery of retinal de-tachment. A minimal approach. Ophthalmology 1996; 103(10): 1586−92.

Thompson JT. The effects and action of scleral buckles in treat-ment of retinal detachment. In: Ryan SJ, editor. Retina. 4ed. St. Louis: Mosby; 2006. p. 2021−34.

Lee EJ. Use of nitrous oxide causing severe visual loss 37 days after retinal surgery. Br J Anaesth 2004; 93(3): 464−6.

Heimann H, Bartz-Schmidt KU, Bornfeld N, Weiss C, Hilgers RD, Foerster MH. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment: a prospective randomized multicenter clinical study. Ophthalmology 2007: 114(2): 2142−54.

Martinez-Castillo V, Verdugo A, Boixadera A, García-Arumí J, Corcóstegui B. Menagement of inferior breaks in pseudophakic rhegmatogenous retinal detachment with pars plana vitrectomy and air. Arch Ophthalmol 2005; 123(8): 1078−81.

Lois N, Wong D. Pseudophakic retinal detachment. Surv Oph-thalmol 2003; 48(5): 467–87.

Rodriguez de la Rúa E, Pastor JC, Aragón J, Mayo-Iscar A, Martínez V, García-Arumí J, et al. Interaction between surgical procedure for repairing retinal detachment and clinical risk factors for proliferative vitreoretinopathy. Curr Eye Res 2005; 30(2): 147−53.

Heimann H, Bartz-Schmidt KU, Bornfeld N, Weiss C, Hilgers R, Foerster MH. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment. A prospective rando-mized multicenter clinical study. Ophthalmology 2007; 114(12): 2142−54.

Heimann H, Bornfeld N, Bartz-Schmidt UK, Hilgers RD, Heussen N. Anaylsis of the surgeon factor in the treatment results of rhegmatogenous retinal detachment in the scleral buckling ver-sus primary vitrectomy in rhegmatogenous retinal detachment study. Klin Monbl Augenheilkd 2009; 226(12): 991−8. (Ger-man)

Oshima Y, Emi K, Motokura M, Yamanishi S. Surgical indications and results of primary pars plana vitrectomy for rhegmatogen-ous retinal detachment. Nihon Ganka Gakkai Zasshi 1998; 102(6): 389−94. (Japanese)

Azad RV, Chanana B, Sharma YR, Vohra R. Primary vitrectomy versus conventional retinal detachment surgery in phakic rhegmatogenous retinal detachment. Acta Ophthalmol Scand 2007; 85(5): 540−5.

Objavljeno
2015/04/24
Broj časopisa
Vol. 71 Br. 10 (2014)
Rubrika
Originalni članak