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Comparison of Two Techniques in the Management of Retinal Detachment with Choroidal Detachment           ★★★
Comparison of Two Techniques in the Management of Retinal Detachment with Choroidal Detachment
作者:Yuping Z… 文章来源:Guangzhou General Hospital of Guangzhou Military Command 点击数:265 更新时间:2011/9/13

Purpose Rhegmatogenous retinal detachment with choroidal detachment is an uncommon occurrence and often associated with ocular hypotony and intraocular inflammation. Single- operation anatomic success rate was low because of high rate of postoperative vitreo-retinal proliferation. This assay is to discuss the techniques for the the management of retinal detachment with choroidal detachment.
Methods One hundred and twenty-three cases of retinal detachment with choroidal detachment who had undergone pars plana vitrectomy (PPV) were retrospected. Of which 86 cases had undergone PPV combined with scleral buckling (Group 1), 37 cases had undergone PPV with intraoperative intravitreal injection of triamcinolone acetonide (Group 2). The anatomic reattachment rate, intraocular imflammatory reaction, postoperative retinal proliferation and complications were compared between the two groups.
Results Two of the eighty-six cases of Group 1 ( 2.3% ) and two of the 37 cases of Group 2 ( 5.4% ) had received second reattachment surgery, all after removal of silicone oil. Middle to severe humour reaction was observed in 7 cases in Group 1 ( 8.1% ) and 2 in Group 2 ( 5.4% ). Inferior retinal proliferation was observed in 5 cases in Group 1 ( 5.8% ) and 1 in Group ( 2.7% ). The main complication was intraocular pressure (IOP) elevation, and it was observed in 11 cases in Group 1 (12.8% ) and 4 in Group 2 (10.8 % ) one week after surgery, and 1 case in Group 1 ( 1.2% ) and 3 in Group 2 ( 8.1% ) one month after surgery. 
Conclusion Both techniques are effective in managing retinal detachment with choroidal detachment. PPV with scleral buckling can obtain high reattachment rate, and PPV with intravitreal triamcinolone can reach lower rate of imflammatory reaction and postoperative proliferation. Attention should be paid to observe IOP postoperatively with both techniques.

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