Barbosa Gabriel Castilho Sandoval, Silva Allan Gomes da, Daher Gonçalves Monteiro Dos Reis Guilherme, Bermudes Frederico Hackbart, Lemos Carolina Maria Barbosa, Garcia Rafael, Mazzeo Thiago José Muniz Machado, Machado Cleide Guimarães, Gomes André Marcelo Vieira
Department of Ophthalmology, Suel Abujamra Institute, São Paulo, Brazil.
Department of Ophthalmology, University of São Paulo, São Paulo, Brazil.
Int J Retina Vitreous. 2022 Oct 1;8(1):73. doi: 10.1186/s40942-022-00420-1.
To describe the anatomical and functional outcomes and late complications in patients who developed inferior proliferative vitreoretinopathy (PVR) in silicone oil-filled eyes and who required reoperation with large inferior retinectomy.
This is a single-center, retrospective, interventional case series analysis. The study involved 18 individuals with tractional retinal re-detachment due to PVR development inferiorly in eyes who had undergone prior pars plana vitrectomy and silicone oil as a tamponade. All patients included in the study underwent secondary surgery with large inferior retinectomy (from 120° to 270°) and silicone oil filling.
The mean follow-up period was 44.0 ± 31.5 (± SD) months (range: 4 to 96 months. The anatomical success, defined as the complete reattachment of the retina until the last follow-up, was observed in 88.9% of the cases. The postoperative visual acuity ranged from 20/100 to hand motion at 60 cm. Only two cases (11.1%) did not achieve anatomical success at the last follow-up due to recurrent PVR and retinal re-detachment (one including hypotony). All of the patients were pseudophakic. The PVR grade, as well as the presence of PVR prior to primary surgery, showed no statistical correlation with BCVA, the extent of retinectomies, and final macular status. There was a statistically significant correlation between "Final BCVA" and "Initial BCVA" (r = 0.654) and between "Final BCVA" and "Extent of Retinectomy" (r = 0.615).
Reoperation in eyes filled with silicone oil may be required when PVR is developed. Secondary surgery in these cases with large inferior retinectomy and silicone oil implantation may reach good anatomical success with low rates of late complications, besides improving visual acuity. A better BCVA at the time of re-RD diagnosis and cases of retinectomies with greater extensions showed a positive correlation with better functional outcomes. Trial registration Research Ethics Committee of the Suel Abujamra Institute reviewed and approved this study protocol (approval number, 5.404.961).
描述硅油填充眼发生下方增殖性玻璃体视网膜病变(PVR)且需要进行大范围下方视网膜切除术再次手术的患者的解剖和功能结果以及晚期并发症。
这是一项单中心、回顾性、干预性病例系列分析。该研究纳入了18例因下方PVR发展导致牵引性视网膜再脱离的患者,这些患者此前已接受过玻璃体切割术和平坦部玻璃体切除术,并使用硅油作为填塞物。研究中的所有患者均接受了大范围下方视网膜切除术(120°至270°)和硅油填充的二次手术。
平均随访期为44.0±31.5(±标准差)个月(范围:4至96个月)。在88.9%的病例中观察到解剖学成功,定义为直至最后一次随访时视网膜完全复位。术后视力范围为20/100至60 cm处手动。仅2例(11.1%)在最后一次随访时由于复发性PVR和视网膜再脱离(1例包括低眼压)未实现解剖学成功。所有患者均为假晶状体眼。PVR分级以及初次手术前PVR的存在与最佳矫正视力(BCVA)、视网膜切除术范围和最终黄斑状态均无统计学相关性。“最终BCVA”与“初始BCVA”之间(r = 0.654)以及“最终BCVA”与“视网膜切除术范围”之间(r = 0.615)存在统计学显著相关性。
当发生PVR时,可能需要对硅油填充眼进行再次手术。在这些病例中,进行大范围下方视网膜切除术和硅油植入的二次手术除了可提高视力外,还可能获得良好的解剖学成功且晚期并发症发生率较低。再次视网膜脱离(RD)诊断时较好的BCVA以及更大范围视网膜切除术的病例与更好的功能结果呈正相关。试验注册 苏埃尔·阿布贾姆拉研究所研究伦理委员会审查并批准了本研究方案(批准号,5.404.961)。