巩膜扣带术治疗黄斑裂孔视网膜脱离后巩膜扣带术后眼内液的影响。

Influence of systemic steroids on subretinal fluid after scleral buckle surgery for macula-off retinal detachment.

机构信息

Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan.

出版信息

Retina. 2011 Jan;31(1):99-104. doi: 10.1097/IAE.0b013e3181e3789c.

DOI:10.1097/IAE.0b013e3181e3789c

PMID:20890243

Abstract

PURPOSE

To investigate the effect of postoperative systemic steroid therapy on the incidence and duration of the subretinal fluid (SRF) and its correlation with the visual outcome after scleral buckle surgery for macula-off rhegmatogenous retinal detachment.

METHODS

Prospective interventional study of sixty patients with macula-off rhegmatogenous retinal detachment who undertook scleral buckle surgery. Those patients who had recurrent retinal detachment, proliferative preretinal membrane, or primary surgical failure were excluded. Patients were assigned to Group 1 (with prescription of oral prednisolone for 3 days postoperatively) and Group 2 (with no such prescription).Furthermore, patients in Group 1 were subdivided into Group 1A (0.5 mg prednisolone/kg)and Group 1B (1 mg prednisolone/kg) according to the dosage of prednisolone. Patients were followed-up initially 1 week and 2 weeks after surgery and then on a monthly basis for at least 1 year. After the operation, all patients had corrected visual acuity and also received examinations of indirect ophthalmoscopy and optical coherence tomography. We compared the incidence, duration of SRF, and the correlation with the visual outcome between the groups.

RESULTS

Lower incidence of SRF was noted in Group 1 than in Group 2 (56.7% vs. 80%;P = 0.052), and the duration of SRF was significantly shorter in Group 1 than in Group 2 (218 days vs. 286 days; P = 0.039). There was no significant difference in the final BCVA between the two groups. However, patients in Group 1 had greater improvements of BCVA 1 year after operation (13 lines vs. 7 lines in Groups 1 and 2, respectively; P = 0.026). Statistically,there were no difference between Groups 1A and 1B, in terms of the incidence of SRF,duration of SRF, final BCVA, and improvement of BCVA.

CONCLUSION

Postoperative systemic steroid treatment may decrease the incidence of SRF and facilitate the absorption of SRF. Patients treated with steroids had greater improvement of BCVA.

摘要

目的

研究术后全身皮质类固醇治疗对孔源性视网膜脱离外垫压术后视网膜下液（SRF）的发生和持续时间的影响，并探讨其与术后视力结果的相关性。

方法

对 60 例孔源性视网膜脱离外垫压术后黄斑脱离患者进行前瞻性干预研究。排除复发性视网膜脱离、增生性视网膜前膜或初次手术失败者。将患者分为 1 组（术后给予 3 天泼尼松龙口服治疗）和 2 组（未予泼尼松龙治疗）。此外，1 组患者根据泼尼松龙剂量进一步分为 1A 组（0.5mg/kg）和 1B 组（1mg/kg）。术后 1 周和 2 周及此后每月进行至少 1 年的随访。所有患者在术后均进行了矫正视力检查，并接受了间接检眼镜和光学相干断层扫描检查。比较各组 SRF 的发生率、持续时间及其与视力结果的相关性。

结果

1 组 SRF 的发生率明显低于 2 组（56.7% vs. 80%；P = 0.052），1 组 SRF 的持续时间明显短于 2 组（218 天 vs. 286 天；P = 0.039）。两组最终 BCVA 无显著差异。然而，术后 1 年时 1 组患者的 BCVA 改善更为明显（13 行 vs. 1 组和 2 组分别为 7 行；P = 0.026）。1A 组和 1B 组在 SRF 发生率、SRF 持续时间、最终 BCVA 和 BCVA 改善方面均无统计学差异。