Moharram Hossam Mohamed, Abdelhalim Ahmed Shawkat, Hamid Mohamed Abdel, Abdelkader Mohamed Farouk
Department of Ophthalmology, Faculty of Medicine, Minia University, Minia, Egypt.
Clin Ophthalmol. 2020 Jan 15;14:127-132. doi: 10.2147/OPTH.S237783. eCollection 2020.
The purpose of this study is to compare anatomical and visual outcomes after using silicone oil (SO) or CF gas as tamponades after pars plana vitrectomy (PPV) for retinal detachment (RD) associated with giant retinal tears (GRTs).
A retrospective chart review was conducted for cases that underwent PPV for GRT-associated RD. We excluded eyes that had prior vitreoretinal surgery, a history of ocular trauma or worse than grade B proliferative vitreoretinopathy (PVR). Baseline demographic and ocular characteristics, surgical details and postoperative anatomical and visual outcomes were recorded and statistically analyzed.
We included 88 eyes; 48 eyes had CF gas and 40 eyes had SO as a tamponading agent. Mean age was 39 years. All eyes underwent 23G PPV with no adjuvant scleral buckling and phacovitrectomy was performed for all phakic eyes. Final retinal reattachment was achieved in 86 eyes (97.7%). One eye from each group had recurrent RD. Postoperative vision was significantly better in the gas group (p= 0.008). Prolonged increase of IOP developed in 6 eyes in the SO group and 5 eyes in the gas group. Prolonged uveitis developed in 4 eyes in the gas group and 6 eyes in the oil group (P= 0.04). Epiretinal membranes (ERM) developed in 10 eyes in the gas group and 9 eyes in the oil group. We found no significant difference between both groups regarding postoperative glaucoma or ERM formation.
Both agents achieved similar favorable anatomical outcomes in a series of eyes with fresh GRT-associated RD and low-grade PVR, with better visual outcome and less frequent uveitis associated with the use of gas tamponade.
本研究旨在比较在玻璃体视网膜手术(PPV)治疗与巨大视网膜裂孔(GRT)相关的视网膜脱离(RD)后,使用硅油(SO)或全氟丙烷(CF)气体作为填塞剂的解剖学和视觉效果。
对因GRT相关的RD接受PPV的病例进行回顾性病历审查。我们排除了曾接受过玻璃体视网膜手术、有眼外伤史或增殖性玻璃体视网膜病变(PVR)程度超过B级的眼睛。记录并统计分析基线人口统计学和眼部特征、手术细节以及术后解剖学和视觉效果。
我们纳入了88只眼;48只眼使用CF气体,40只眼使用SO作为填塞剂。平均年龄为39岁。所有眼睛均接受了23G PPV,未进行辅助巩膜扣带术,所有有晶状体眼均进行了晶状体玻璃体切除术。86只眼(97.7%)最终实现了视网膜复位。每组各有一只眼发生复发性RD。气体组术后视力明显更好(p = 0.008)。SO组有6只眼眼压持续升高,气体组有5只眼眼压持续升高。气体组有4只眼发生持续性葡萄膜炎,油剂组有6只眼发生持续性葡萄膜炎(P = 0.04)。气体组有10只眼形成视网膜前膜(ERM),油剂组有9只眼形成视网膜前膜。我们发现两组在术后青光眼或ERM形成方面无显著差异。
在一系列伴有新鲜GRT相关RD和低度PVR的眼中,两种填塞剂均取得了相似的良好解剖学效果,使用气体填塞时视觉效果更好,葡萄膜炎发生率更低。