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[摘要]
目的：分析西班牙某三级医院视网膜科接受手术治疗的黄斑裂孔性视网膜脱离患者。着重强调诊断与手术之间的时间间隔，试图寻找术前时间与视力下降之间的关系。
方法：回顾性研究。包括77例在Universitario Fundación Jiménez Díaz医院接受手术治疗的黄斑裂孔性视网膜脱离患者。
结果：77例患者中有72例(72眼)参与了该研究。初步手术成功率为94.44%(68/72)，采取1或2次干预措施后，全部患者成功率为98.61%(71/72)。术前平均时间为5.3±2.26d。7(9.72%)例患者视力下降2行或更多。视力下降与患者年龄之间具有统计学意义(P=0.001)。研究表明进一步手术干预使视网膜再次附着与视力下降检测之间存在相关联系(P=0.045)。而研究未能发现视力下降与术前时间(P=0.100)，手术类型(P=0.578)或晶状体状态(P=0.413)之间具有统计学意义。
结论：每家医院都应该研究治疗此类型视网膜脱离治疗的方式，以优化利用现有资源，确保最佳的解剖结构复位和功能恢复。
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[Abstract]
AIM: To analyze the management of patients with macula-on retinal detachment who received surgical treatment in our department. Placing special emphasis on the time elapsed between diagnosis and surgery, we sought to establish whether a relationship exists between time to surgery and loss of visual acuity.
METHODS: A retrospective study in which the medical records of 77 patients with macula-on retinal detachment who underwent surgery in Hospital Universitario Fundación Jiménez Díaz were reviewed.
RESULTS: A total of 77 patients, 72 were included in the study. The primary anatomic success rate was 94.44%(68/72), and the success rate in all patients after either 1 or 2 interventions was 98.61%(71/72). The mean time before surgery was 5.3±2.26d. Seven patients(9.72%)lost two or more lines of vision. A statistically significant relationship was found between loss of visual acuity and patient age(P=0.001). Our findings also suggest a possible link between the need for further surgical intervention to reattach the retina and decline in visual acuity test(P=0.045). We failed to find a statistically significant relationship between loss of visual acuity and days until surgery(P=0.100)or type of surgery(P=0.578)or status of the crystalline lens(P=0.413).
CONCLUSION: It is important that each hospital study how this type of retinal detachment is being managed in order to optimize the use of available resources and guarantee the most favorable anatomic and functional outcomes possible.
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