Department of Ophthalmology, Rambam Health Care Campus, Technion-Israel Institute of Technology, Haifa, Israel; and.
Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Retina. 2020 Jun;40(6):1153-1159. doi: 10.1097/IAE.0000000000002565.
To identify factors associated with persistent subretinal fluid (SRF) after small-gauge pars plana vitrectomy for primary rhegmatogenous retinal detachment.
This retrospective study included patients from 2 tertiary centers who underwent pars plana vitrectomy for repair of rhegmatogenous retinal detachment between 2013 and 2016. Preoperative and intraoperative parameters were examined for association with development of SRF.
Overall, 153 eyes of 153 patients, mean age of 55.2 ± 17.9 years were included. Persistent SRF occurred in 15.0% (n = 23) and was associated with high myopia (65.22 vs. 26.15%, P < 0.001), macula-involving retinal detachment (91.30 vs. 66.15%, P = 0.02), phakic lens status (86.96 vs. 66.15%, P = 0.04), and younger age (47.8 ± 18.7 vs. 56.5 ± 17.5, P = 0.04) while drainage retinotomy was protective (13.04 vs. 34.11%, P = 0.04). In multivariate analysis, high myopia (P = 0.009) and macula-involving retinal detachment (P = 0.004) were associated with SRF, while drainage retinotomy was protective (P = 0.03). Persistent SRF was associated with outer retinal band irregularity (30.4 vs. 9.3%, P = 0.005). There were no significant differences in terms of change in best-corrected visual acuity from presentation (P = 0.70), or final best-corrected visual acuity (P = 0.54).
Eyes with preoperative high myopia and macular involvement, and those in which a drainage retinotomy was not performed, were more likely to develop persistent SRF.
确定与原发性孔源性视网膜脱离行小切口经睫状体平坦部玻璃体切除术后持续性视网膜下液（SRF）相关的因素。
本回顾性研究纳入了 2013 年至 2016 年间在 2 家三级医院接受经睫状体平坦部玻璃体切除术治疗孔源性视网膜脱离的患者。检查术前和术中的参数与 SRF 的发生发展的关系。
共纳入 153 例 153 只眼，平均年龄 55.2 ± 17.9 岁。15.0%（n=23）的患者出现持续性 SRF，与高度近视（65.22%比 26.15%，P<0.001）、累及黄斑的视网膜脱离（91.30%比 66.15%，P=0.02）、晶状体未摘出（86.96%比 66.15%，P=0.04）和年龄较小（47.8 ± 18.7 比 56.5 ± 17.5，P=0.04）相关，而引流视网膜切开术有保护作用（13.04%比 34.11%，P=0.04）。多变量分析显示，高度近视（P=0.009）和累及黄斑的视网膜脱离（P=0.004）与 SRF 相关，而引流视网膜切开术有保护作用（P=0.03）。持续性 SRF 与外视网膜带不规则有关（30.4%比 9.3%，P=0.005）。从就诊时的最佳矫正视力变化（P=0.70）或最终最佳矫正视力（P=0.54）来看，没有显著差异。
术前近视程度高且黄斑受累，以及未行引流视网膜切开术的眼，更有可能发生持续性 SRF。
