| Part?:The safety and efficacy of puncture and drainage using the 25G needle at 11mm after the cornealimbusin the scleralbuckling surgery for rhegmatogenous retinal detachmentObjective:To observe the safety and efficacy of puncture and drainage in the scleral buckling(SB)using a 25 gauge needle at 11 mm after the cornealimbusin the scleral buckling surgery for rhegmatogenous retinal detachment(RRD).Methods:From June 2013 to November 2018,186 eyes of 183patients who underwent scleral buckling in the Department of Ophthalmology,Jiangsu Subei People's Hospital for the first time due to RRD in the study.There were 97 eyes of 97 males and86 females of 89 eyes.All patients with SB were treated with a 25 gauge needlewas perpendicular to the surface of the sclera to puncture the subretinal fluid at 11mm after the cornea limbus.The data of intraoperative puncture and drainage were collected,and the postoperative condition was followed up.The success rate of the puncture and drainage method and the incidence of intraoperative and postoperative complications were analyzed,compared with other methods of puncture and drainage.Results:186 eyes of 183 patients with scleral buckling were treated with a 25gauge needle at 11mm after the limbus.During the operation,186 cases(100%)were drained the subretinal fluid successfully,and 1 case(0.54%)occurred subretinal hemorrhage,no other intraoperative complications.106 eyes were followed up,the follow-up period was 3 months to 5 years,with an average of(30.84±18.01)months.The 106 eyes,100 eyes were reattached successfully,accounting for 94.3%,6 eyes(5.7%)were failingand adopted pars plana vitrectomy(PPV).One eye(0.94%)happened external strabismus and one eye happend protrusion(0.94%)after operation.Conclusion:The puncture drainage at 11mm after the cornealimbus of the 25G needle in scleral buckling surgery is a safe and effective method of drainage.Part?:Analysis of factors related to continuous subretinal fluidafter scleral bucklingObjective:To observe and analyze the factors related to the production of persistent subretinal fluid(PSF)after scleral buckling,and to provide evidence for the prognosis of subretinal fluid after scleral buckling.Methods:A retrospective study.The date of 77 consecutive primary scleral bucking patients(80 eyes)were enrolled in the study.One month after operation,the optical coherence tomography(OCT)was executed.The patients were divided into two group with PSF and without PSF in postoperative.The preoperative basic data and follow-up data were recorded,including the patient's age,duration of disease,number and location of retinal tears,location and quadrant of retinal detachment,axial length,diopter,PVR grading,whether have retinal detachment in macular area,and the method and duration of surgery.Univariate analysis was performed on these data.In order to avoid missing some related factors,P<0.15 was identified as a statistically significant variable with univariate analysis and included in the logistic regression model to find out the factors that correlation with PSF after scleral buckling.Results:Among the 80 eyes,there were 35 eyes without PSF,accounting for 43.8%,and 45 eyes with PSF group,accounting for 56.3%.Among the single factor analysis.Statistically significant different was found in age(t=3.048,(49)=<0.01),duration(t=-3.676,(49)=<0.01),location of the retinal tears(c~2=9.830,(49)=<0.01),location of retinal detachment(c~2=9.125,(49)=0.028),quadrant of retinal detachment(Z=-2.498,(49)=0.012),PVR staging(Z=-3.247,(49)=<0.01),whether the retina of the macular area was detached(c~2=11.987,(49)=<0.01),and the surgical method(c~2=6.237,(49)=0.104).The age,duration of disease in the logistic regression analysis were statistically significant((49)<0.05).Conclusion:The production of PSF after scleral buckling is affected by many factors.The age and duration of disease are related to the production of PSF.Young patients and longer duration of disease are easier to generate PSF after SB. |
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