The clinical observation of segmental scleral bulking in treatment of rhegmatogenous retinal detachment with multiple retinal breaks_Chinese Journal of Ocular Fundus Diseases

Authors：

TianChaowei ,  WangYusheng , DouGuorui , 苏晓娜

Department of Ophthalmology, Xijing Hospital, The Fourth Military Medical University, The Eye Institute of Chinese PLA, Xi'an 710032, China;

Corresponding author：

WangYusheng, Email: wangys003@126.com

Keywords：

Retinal detachment/surgery; Scleral buckling

DOI：

10.3760/cma.j.issn.1005-1015.2014.04.006

Video：

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Objective To observe the effect of segmental scleral buckling on the treatment of rhegmatogenous retinal detachment (RRD) with multiple retinal breaks. Methods This is a retrospective study. Seventeen patients (17 eyes) suffering from RRD with multiple retinal breaks were enrolled in this study. There were 8 eyes with the retinal breaks located in different quadrants and 9 eyes located in different latitudes within the same quadrant. Three were 3 eyes with 2 retinal breaks, 5 eyes with 3 retinal breaks, 9 eyes with more than 3 retinal breaks. The forms of retinal breaks included U-shaped break (4 eyes), tear break (1 eye), degenerative break (3 eyes) or U-shaped breaks combined with degenerative breaks (7 eyes), U-shaped breaks combined with tear breaks (1 eye), tear breaks combined with degenerative breaks (1 eye). The best corrected vision acuity (BCVA) was count finger to 0.8. The segmental scleral buckling was performed in all patients with the reasonable combination of silicon sponges and tires. The mean follow-up was 9.3 months (from 6 to 12 months). The BCVA, retinal attachment and complications were observed in the follow-up. Results Fifteen eyes were reattached without recurrent of retinal detachment (88.2%). One eye with recurrent retinal detachment after 3 months due to proliferative vitreoretinopathy, and was partly reattached after vitrectomy combined with silicon oil tamponade. Retina remained detached in 2 eyes (11.8%), including 1 eye reattached after combined with gas tamponade, and 1 eye with vitrectomy. Sixteen eyes were completely reattached (94.1%), including 14 eyes were underwent only 1 operation (82.4%). The BCVA were improved more than 2 lines in 9 eyes (52.9%), 1 to 2 lines in 5 eyes (29.4%), and only 3 eyes (17.7%) without improvement. All patients have no serious complications during the operations. Conclusion For certain patients suffering from RRD with multiple retinal breaks, a reasonable design of segmental scleral buckling can effectively increase the success rate of retinal reattachment (82.4%).

Citation： TianChaowei, WangYusheng, DouGuorui. The clinical observation of segmental scleral bulking in treatment of rhegmatogenous retinal detachment with multiple retinal breaks. Chinese Journal of Ocular Fundus Diseases, 2014, 30(4): 357-360. doi: 10.3760/cma.j.issn.1005-1015.2014.04.006 Copy

1.	吴雅臻, 唐庆新, 张晓光.多裂孔视网膜脱离的手术治疗[J].中国实用眼科杂志, 1999, 17:446-447.
2.	蒋永祥, 郭希让, 黄爱国.改进宽环扎治疗周边多裂孔性视网膜脱离[J].眼科研究, 2003, 21:233.
3.	赵秉水, 张斌, 赵芳, 等.伴有前瓣牵引的多发裂孔性视网膜脱离的玻璃体切割术与单纯巩膜扣带术的临床疗效分析[J].中华眼底病杂志, 2004, 20:209-211.
4.	王文吉.孔源性视网膜脱离的手术选择[J].中国眼耳鼻喉科杂志, 2003, 3:73-75.
5.	张少冲, 刘恬.视网膜脱离手术方案的选择[J].中华眼科杂志, 2003, 39:766-768.
6.	张少冲, 刘恬.视网膜脱离的现代手术治疗[M]//杨培增, 陈家琪, 葛坚, 等.眼科学基础与临床.北京:人民卫生出版社, 2006:725-735.
7.	Heimann H, Hellmich M, Bornfeld N, et al. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment (SPR Study):design issues and implications.SPR Study Report No. 1[J].Graefe's Arch Clin Exp Ophthalmol, 2001, 239:567-574.
8.	Sun Q, Sun T, Xu Y, et al.Primary vitrectomy versus scleral buckling for the treatment of rhegmatogenous retinal detachment: a meta-analysis of randomized controlled clinical trials[J]. Curr Eye Res, 2012, 37:492-499.
9.	董方田.以严谨求实的科学态度开展玻璃体视网膜手术[J].中华眼科杂志, 2001, 37:161-163.
10.	惠延年.原发性视网膜脱离的手术选择[J].眼科, 2005, 14:221-223.
11.	应海燕, 王方.视网膜脱离巩膜扣带手术的历程与新动向[J].临床眼科杂志, 2008, 16:570-573.
12.	赵东生.视网膜破口[M]//赵东生.视网膜脱离手术学.上海:上海科技教育出版社, 1999:83-100.
13.	Lincoff H. Radial buckling in the repair of retinal detachment[J].Int Ophthalmol Clin, 1976, 16:127-134.
14.	Lincoff H, Kreissig I.Advantages of radial buckling[J].Am J Ophthalmol, 1975, 79:955-957.
15.	田超伟, 王雨生, 张朝霞, 等.巩膜外垫压术治疗直肌下裂孔视网膜脱离的临床观察[J].眼科, 2010, 19:257-259.
16.	Kreissig I.视网膜脱离最小量手术治疗实用指南(1)[M].惠延年, 译.北京:北京科学技术出版社, 2004:155-169.

1. 吴雅臻, 唐庆新, 张晓光.多裂孔视网膜脱离的手术治疗[J].中国实用眼科杂志, 1999, 17:446-447.
2. 蒋永祥, 郭希让, 黄爱国.改进宽环扎治疗周边多裂孔性视网膜脱离[J].眼科研究, 2003, 21:233.
3. 赵秉水, 张斌, 赵芳, 等.伴有前瓣牵引的多发裂孔性视网膜脱离的玻璃体切割术与单纯巩膜扣带术的临床疗效分析[J].中华眼底病杂志, 2004, 20:209-211.
4. 王文吉.孔源性视网膜脱离的手术选择[J].中国眼耳鼻喉科杂志, 2003, 3:73-75.
5. 张少冲, 刘恬.视网膜脱离手术方案的选择[J].中华眼科杂志, 2003, 39:766-768.
6. 张少冲, 刘恬.视网膜脱离的现代手术治疗[M]//杨培增, 陈家琪, 葛坚, 等.眼科学基础与临床.北京:人民卫生出版社, 2006:725-735.
7. Heimann H, Hellmich M, Bornfeld N, et al. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment (SPR Study):design issues and implications.SPR Study Report No. 1[J].Graefe's Arch Clin Exp Ophthalmol, 2001, 239:567-574.
8. Sun Q, Sun T, Xu Y, et al.Primary vitrectomy versus scleral buckling for the treatment of rhegmatogenous retinal detachment: a meta-analysis of randomized controlled clinical trials[J]. Curr Eye Res, 2012, 37:492-499.
9. 董方田.以严谨求实的科学态度开展玻璃体视网膜手术[J].中华眼科杂志, 2001, 37:161-163.
10. 惠延年.原发性视网膜脱离的手术选择[J].眼科, 2005, 14:221-223.
11. 应海燕, 王方.视网膜脱离巩膜扣带手术的历程与新动向[J].临床眼科杂志, 2008, 16:570-573.
12. 赵东生.视网膜破口[M]//赵东生.视网膜脱离手术学.上海:上海科技教育出版社, 1999:83-100.
13. Lincoff H. Radial buckling in the repair of retinal detachment[J].Int Ophthalmol Clin, 1976, 16:127-134.
14. Lincoff H, Kreissig I.Advantages of radial buckling[J].Am J Ophthalmol, 1975, 79:955-957.
15. 田超伟, 王雨生, 张朝霞, 等.巩膜外垫压术治疗直肌下裂孔视网膜脱离的临床观察[J].眼科, 2010, 19:257-259.
16. Kreissig I.视网膜脱离最小量手术治疗实用指南(1)[M].惠延年, 译.北京:北京科学技术出版社, 2004:155-169.

Chinese Journal of Ocular Fundus Diseases

The clinical observation of segmental scleral bulking in treatment of rhegmatogenous retinal detachment with multiple retinal breaks

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