ClinicalobservationsofvitreoretinalsurgeryforfourdifferentphenotypesofX-linkedcongenitalretinoschisis

摘要： AIM:ToevaluatetheoutcomesofvitreoretinalsurgeryforfourdifferentphenotypesofX-linkedretinoschisis(XLRS).METHODS:Thisstudyincludedthirty-oneeyesof25patientswhodevelopedXLRSwithseverecomplications.Amongthe31eyes,therewere7eyeswithvitreoushemorrhage,8eyeswithretinaldetachmentandvitreoushemorrhage,and16eyeswithrhegmatogenousretinaldetachment.Allofthepatientsunderwentstandardthreeportparsplanavitrectomy.Alloftheeyesweredividedinto4groupsbeforesurgeryaccordingtoamodifiedclassificationscheme,withthefirstthreegroupsasfollows:groupA,withfovealcysticschisis;groupBwithmacularlamellarschisis;andgroupCwithfoveolamellarchanges.Peripheralschisiswasnotpresentinthese3groups;however,groupDwasacomplexgroupwithbothmacularandperipheralchanges.Oneyearaftersurgery,weanalyzedthebestcorrectedvisualacuityandpostoperativeanatomicalandfunctionaloutcomesofthese4groups.RESULTS:Therewere7eyesingroupA(22.6%),1eyeingroupB(3.2%),15eyesingroupC(48.4%)and8eyesingroupD(25.8%).Postoperativeanatomicalandfunctionaloutcomesweresatisfactoryatthelastvisit,whilethemeanvisualacuitywasincreasedto0.27±0.11,withasignificantdifference(t=-1.049,P=0.000)comparedwiththeresultsbeforesurgery(0.1±0.08).Visualacuitywasimprovedin23eyes(74.2%).Complicationswerefoundinthreeeyes:twoeyeswithproliferativevitreoretinopathyandtractionretinaldetachment10and12moaftersurgery,respectively;andoneeyewithvitreoushemorrhage15moaftersurgery.TheseeyeswereingroupsCandD.Theretinasremainedattachedinthese3eyesafterreoperation.CONCLUSION:WeshouldpaygreaterattentiontoXLRSwithfoveolamellarchangesbecauseitisthemostchangeablephenotype.Oncecomplicationsoccur,vitreoretinalsurgerycansignificantlyimprovevisualacuityandrestoretheanatomicstructureoftheretina. ... （共5页）