Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Retina. 2018 Feb;38(2):310-319. doi: 10.1097/IAE.0000000000001533.
To evaluate and compare the effect of silicone oil and gas on the thickness of all retinal layers in eyes with macula-on retinal detachment (RD).
Three hundred and sixty-seven eyes of 367 patients who received silicone oil tamponade and 310 eyes of 310 patients who received gas tamponade for the treatment of rhegmatogenous RD were initially reviewed. Automated retinal segmentation method using Spectralis optical coherence tomography was used for analysis. The primary outcome measure was the change in thickness of each retinal layer in the central 1 mm zone (silicone oil vs. gas tamponade). The secondary outcome measure was best-corrected visual acuity at postoperative 6 months and 9 months after primary RD surgery.
Eyes in the silicone oil group (n = 33) had a statistically significant decrease in total retinal thickness of 23.61 + 17.01 μm and in the thickness of all retinal layers, except for photoreceptor layer at 6 months after primary RD surgery (P < 0.001). In the gas group (n = 31), the postoperative change in total retinal thickness was only 0.14 ± 7.26 μm (P = 0.93), with no significant decrease in any of the individual retinal layers. Postoperatively, the best-corrected visual acuity in the silicone oil groups was significantly worse than that in the gas group at 6 months and 9 months after RD surgery (P = 0.003 and P = 0.004, respectively). The postoperative decrease of the ganglion cell layer, outer plexiform layer, and outer nuclear layer thicknesses showed significant correlation with best-corrected visual acuity in the silicone oil group (all P < 0.05).
Silicone oil tamponade had a significant impact on the reduction of retinal thickness and that the reduction of ganglion cell layer, outer plexiform layer, and outer nuclear layer thicknesses showed the strongest correlation with worse visual acuity outcome.
评估并比较硅油和气体对黄斑区视网膜脱离（RD）眼所有视网膜层厚度的影响。
最初回顾了 367 例接受硅油填充和 310 例接受气体填充治疗孔源性 RD 的 367 只眼和 310 只眼。使用 Spectralis 光学相干断层扫描仪进行自动视网膜分层方法分析。主要观察指标为中央 1mm 区各视网膜层厚度的变化（硅油与气体填充）。次要观察指标为原发性 RD 手术后 6 个月和 9 个月时最佳矫正视力。
硅油组（n=33）在原发性 RD 手术后 6 个月时，总视网膜厚度统计学上显著减少 23.61+17.01μm，除感光细胞层外，所有视网膜层厚度均减少（P<0.001）。在气体组（n=31）中，术后总视网膜厚度的变化仅为 0.14±7.26μm（P=0.93），各视网膜层厚度无明显减少。术后硅油组最佳矫正视力明显差于气体组，在 RD 手术后 6 个月和 9 个月时（P=0.003 和 P=0.004）。硅油组的神经节细胞层、外丛状层和外核层厚度的术后下降与最佳矫正视力呈显著相关性（均 P<0.05）。
硅油填充对视网膜厚度的降低有显著影响，神经节细胞层、外丛状层和外核层厚度的降低与视力预后较差有最强的相关性。
