Department of Vitreoretina, Disha Eye Hospitals Pvt Ltd, 88(63A) Ghosh Para Road, Barrackpore, Kolkata, 700120, West Bengal, India.
Department of Vitreoretina, Siliguri Greater Lions Eye Hospital, 2Nd Mile, Sevoke Rd, Ward 43, Bhanu Nagar, Siliguri, West Bengal, India.
Int Ophthalmol. 2023 Jun;43(6):1867-1876. doi: 10.1007/s10792-022-02586-x. Epub 2022 Dec 10.
To perform a pilot study to evaluate the role of sub-silicone oil Triamcinolone Acetonide (TA) crystal drops in complex Retinal Detachment (RD) with extreme proliferative vitreoretinopathy (PVR) requiring 360-degree relaxing retinectomy (RR).
It was a retrospective pilot study.
It was a retrospective case-control pilot study. TA-assisted 23G or 25G vitrectomy was done in 24 complex RDs with extreme PVR where 360 degree RR had to be performed. Group A (n = 13) included cases where additional TA crystal drops were applied, after settling the detached retina, over the site of RR under silicone oil (SO 5000 CSt) tamponade. In the control arm, group B (n = 11), additional TA crystals were not applied.
Mean pre- and post-operative BCVA, ultra-widefield fundus photograph by Optos 200Tx, macular OCT and the propensity to remove silicone oil were measured.
Mean pre-operative and post-operative BCVA at final follow-up were Log MAR 2.69 ± 0.41 and Log MAR 1.51 ± 0.90 (Mann-Whitney U test, p < 0.05), respectively, in Group A and Log MAR 2.9 and Log MAR 2.37 ± 0.86 (Mann-Whitney U test, p < 0.05), respectively, in group B. Visual improvement in group A was significantly better than group B (Wilcoxon W test, p < 0.025) with significantly less recurrence of RD (Fisher's Exact Test, p = 0.002). Silicone oil removal was done significantly more in group A (Fisher's Exact Test, p = 0.0017).
Sub-silicone oil crystals application over sites of RR after 360-degree relaxing retinectomy leads to improved postoperative visual recovery as well as improved anatomical outcomes with fewer complications.
进行一项初步研究,以评估在伴有极度增生性玻璃体视网膜病变(PVR)的复杂视网膜脱离(RD)中,在需要进行 360 度松解性视网膜切开术(RR)的情况下,亚硅油曲安奈德(TA)晶体滴的作用。
这是一项回顾性初步研究。
这是一项回顾性病例对照初步研究。在 24 例伴有极度 PVR 的复杂 RD 患者中进行了 TA 辅助的 23G 或 25G 玻璃体切除术,需要进行 360 度 RR。A 组(n=13)包括在硅油(SO 5000 CSt)填充下,在 RR 部位额外应用 TA 晶体滴,以稳定脱离的视网膜。在对照组 B 组(n=11)中,未应用额外的 TA 晶体。
测量平均术前和术后最佳矫正视力(BCVA)、Optos 200Tx 超广角眼底照片、黄斑 OCT 和硅油去除的倾向。
A 组的平均术前和最终随访时的术后 BCVA 分别为 LogMAR 2.69±0.41 和 LogMAR 1.51±0.90(Mann-Whitney U 检验,p<0.05),B 组分别为 LogMAR 2.9 和 LogMAR 2.37±0.86(Mann-Whitney U 检验,p<0.05)。A 组的视力改善明显优于 B 组(Wilcoxon W 检验,p<0.025),RD 复发率明显较低(Fisher 精确检验,p=0.002)。A 组硅油去除明显更多(Fisher 精确检验,p=0.0017)。
在 360 度松解性视网膜切开术后,在 RR 部位应用亚硅油晶体可改善术后视力恢复,并改善解剖学结果,减少并发症。