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中国患者视网膜复位手术后取出眼内硅油后视力、眼轴长度和屈光的变化:一项开放标签的前瞻性研究。

Changes in visual acuity, axial length, and refraction after removal of intraocular silicone oil following retinal reattachment surgery in Chinese patients: An open-label, prospective study.

作者信息

Yang An-Huai, Jin Wei, Xing Yi-Qiao

机构信息

Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China.

出版信息

Curr Ther Res Clin Exp. 2009 Jun;70(3):221-7. doi: 10.1016/j.curtheres.2009.06.002.

Abstract

BACKGROUND

As a vitreous substitute for long-term tamponade, silicone oil is widely used in vitreoretinal surgery to treat retinal detachment with proliferative vitreoretinopathy and some internal reconstruction after globe trauma.

OBJECTIVES

The aim of this study was to compare the changes in visual acuity, axial length, and refraction in eyes before and after removal of intraocular silicone oil of 2 different viscosities after retinal reattachment surgery. The difference in the final anatomic success (stable retinal reattachment) rate was also assessed.

METHODS

Patients with surgically reattached retinas were enrolled in this open-label, prospective, nonrandomized study. All patients underwent pars plana vitrecto-my, lensectomy, scleral buckling or encircling, and epiretinal membrane dissection; silicone oil was removed after stable retinal reattachment was achieved. Refraction, axial length, final visual acuity, and stable retinal reattachment were assessed ≤2 days prior to surgery (baseline) and ≤1 month after silicone oil removal. Refraction was measured using an autorefractometer, and axial length was measured using A-scan ultrasonography, while visual acuity was assessed using a standard Snellen chart.

RESULTS

Of the 96 eyes assessed for inclusion, 89 eyes of 89 Chinese patients (mean [SD] age, 36.8 [4.3] years) were included in the study. Forty-two eyes (47.2%) were filled with 3700-centistoke (cS) silicone oil and 47 (52.8%) were filled with 5000-cS silicone oil. The mean interval between instillation and removal of the silicone oil was similar between the 3700-cS and 5000-cS groups (5.37 vs 5.10 months, respectively). The mean changes in visual acuity from before surgery to after removal of the silicone oil in the 3700-cS and 5000-cS groups were not significantly different (13/100 vs 15/100). The mean increase in axial length was also not significantly different in the 3700-cS group compared with the 5000-cS group (11.92 [1.97] vs 12.33 [1.28] mm). Mean decrease in refraction was significantly lower in the 3700-cS group compared with the 5000-cS group (5.80 [1.51] vs 6.88 [2.31] diopters; t = 2.57, P < 0.05). The anatomic success rate was 92.9% (39/42 patients) in the 3700-cS group and 91.5% (43/47) in the 5000-cS group.

CONCLUSIONS

A statistically significant decrease in refraction from baseline was found in the 3700-cS group compared with the 5000-cS group in these Chinese patients who underwent instillation and removal of silicone oil after retinal reattachment surgery. There were no other statistically significant differences between the 2 groups.

摘要

背景

作为一种用于长期填塞的玻璃体替代物,硅油在玻璃体视网膜手术中被广泛用于治疗伴有增殖性玻璃体视网膜病变的视网膜脱离以及眼球外伤后的一些眼内重建。

目的

本研究旨在比较视网膜复位手术后取出两种不同黏度眼内硅油前后患眼的视力、眼轴长度和屈光变化。同时评估最终解剖学成功率(视网膜复位稳定)的差异。

方法

本开放标签、前瞻性、非随机研究纳入了视网膜手术复位的患者。所有患者均接受了玻璃体切割术、晶状体切除术、巩膜扣带术或环扎术以及视网膜前膜剥离术;在视网膜复位稳定后取出硅油。在手术前≤2天(基线)和取出硅油后≤1个月评估屈光、眼轴长度、最终视力和视网膜复位稳定情况。使用自动验光仪测量屈光,使用A超超声检查测量眼轴长度,使用标准Snellen视力表评估视力。

结果

在评估纳入的96只眼中,89例中国患者的89只眼(平均[标准差]年龄,36.8[4.3]岁)被纳入研究。42只眼(47.2%)填充3700厘沲(cS)硅油,47只眼(52.8%)填充5000-cS硅油。3700-cS组和5000-cS组硅油注入与取出之间的平均间隔相似(分别为5.37个月和5.10个月)。3700-cS组和5000-cS组从手术前到取出硅油后视力的平均变化无显著差异(分别为13/100和15/100)。3700-cS组与5000-cS组相比,眼轴长度的平均增加也无显著差异(分别为11.92[1.97]mm和12.33[1.28]mm)。3700-cS组与对照组相比,屈光平均降低显著更低(分别为5.80[1.51]和6.88[2.31]屈光度;t=2.57,P<0.05)。3700-cS组的解剖学成功率为92.9%(39/42例患者),5000-cS组为91.5%(43/47)。

结论

在这些视网膜复位手术后注入和取出硅油的中国患者中,3700-cS组与5000-cS组相比,屈光较基线有统计学意义的降低。两组之间无其他统计学显著差异。

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Functional outcome and prognostic factors in 304 eyes managed by retinectomy.视网膜切除术治疗的304只眼的功能预后及预后因素
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