Ratanapakorn Tanapat, Thongmee Watcharaporn, Meethongkam Kidakarn, Sinawat Suthasinee, Sanguansak Thuss, Bhoomibunchoo Chavakij, Laovirojjanakul Wipada, Yospaiboon Yosanan
KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Clin Ophthalmol. 2020 Feb 7;14:359-367. doi: 10.2147/OPTH.S242804. eCollection 2020.
To study silicone oil (SO) emulsification, anatomic and visual outcome after complicated retinal detachment surgery by pars plana vitrectomy (PPV) with intraocular SO tamponade, comparing between low and high viscosity SO.
Randomized, double-blinded, controlled trial.
Patients with complicated retinal detachment who had been surgically treated by PPV and intraocular SO tamponade were randomly divided into low viscosity (Group 1) or high viscosity (Group 2). Main Outcome Measures were rate of silicone oil emulsification, anatomic retinal reattachment and visual outcome, assessed at 1,3,6,9 and 12 months.
One hundred patients were divided into 50 patients in each group. The rate of silicone oil emulsification in Group 1 (63.64%) was higher than Group 2 (40%), but the difference was not statistically significant (p = 0.08). Rates of anatomic retinal reattachment were 88% in Group 1 and 90% in Group 2 (p = 0.76). For functional visual outcome, final best-corrected visual acuity (BCVA) at Month 12 compared with the baseline BCVA was improved vision 52% in Group 1 and 58% in Group 2 (p = 0.82).
SO emulsification rate in low viscosity group is non-significantly higher than high viscosity group, but results in a comparable reattachment rate and final visual recovery. Emulsification in both groups is detected at as early as 1 month and mostly within 3 months. We recommend using either low or high viscosity SO in complicated retinal detachment surgery and removing it as early as possible to prevent the consequent serious complications.
ClinicalTrials.gov Identifier: NCT02988583.
研究在复杂性视网膜脱离手术中,经平坦部玻璃体切除术(PPV)联合眼内硅油填塞后,低粘度和高粘度硅油的乳化情况、解剖学及视觉预后。
随机、双盲、对照试验。
接受PPV及眼内硅油填塞手术治疗的复杂性视网膜脱离患者被随机分为低粘度组(第1组)和高粘度组(第2组)。主要观察指标为硅油乳化率、视网膜解剖复位情况及视觉预后,分别在术后1、3、6、9和12个月进行评估。
100例患者被分为每组50例。第1组的硅油乳化率(63.64%)高于第2组(40%),但差异无统计学意义(p = 0.08)。第1组的视网膜解剖复位率为88%,第2组为90%(p = 0.76)。在功能性视觉预后方面,第12个月时最终最佳矫正视力(BCVA)与基线BCVA相比,第1组视力改善52%,第2组为58%(p = 0.82)。
低粘度组的硅油乳化率略高于高粘度组,但差异无统计学意义,且二者的视网膜复位率及最终视觉恢复情况相当。两组均在术后1个月即可检测到乳化,且大多在3个月内出现。我们建议在复杂性视网膜脱离手术中使用低粘度或高粘度硅油,并尽早取出以预防随之而来的严重并发症。
ClinicalTrials.gov标识符:NCT02988583。