Moussa George, Tadros Maria, Ch'ng Soon Wai, Ferrara Mariantonia, Kalogeropoulos Dimitrios, Sharma Ash, Lett Kim Son, Mitra Arijit, Tyagi Ajai K, Andreatta Walter
Birmingham and Midland Eye Centre and Academic Unit of Ophthalmology, University of Birmingham, Birmingham, UK.
Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK.
Int J Retina Vitreous. 2023 Apr 29;9(1):30. doi: 10.1186/s40942-023-00466-9.
To measure the proportion of unexplained and all causes of visual loss following primary rhegmatogenous-retinal-detachment (RRD) repair, comparing gas tamponade (SF, CF, CF), silicone oil (SO, 1000cs and 5000cs) and heavy silicone oil (Densiron).
Retrospective, continuous, comparative study from 01/1/2017-31/5/2021. All primary RRDs were included after successful removal of SO and Densiron. Primary failures were excluded. Visual loss was defined as reduction of ≥0.30 logMAR units. Multivariable binary-logistic and linear regression models to compare tamponade, and all cases of unexplained visual loss and logMAR gain were performed. Covariates included age, ocular co-morbidities, pre-op vision, macula-status, high-myopia, giant-retinal-tear (GRT), perfluorocarbon-use, combined buckle/PPV, PVR-C, retinectomy, tamponade agent and post-operative lens status.
Of 1,012 primary RRDs, we found an incidence of unexplained visual loss in 15/1012 (1.5%, SF:1/341[0.3%], CF:4/338[1.2%], CF:2/239[0.8%], Densiron:0/33[0.0%], SO-1000cs:5/43[11.6%] and SO-5000cs:3/18[16.7%]), and visual loss of all causes in 57/1012 (5.6%, SF:13/341[3.8%], CF:14/338[4.1%], CF:15/239[6.3%], Densiron:2/33[6.1%], SO-1000cs:9/43[20.9%] and SO-5000cs:4/18[22.2%]). On multivariable binary-logistic regression, we report that macula-on RRD (Odds-Ratio[OR]5.7,95% Confidence-interval[CI]1.2-28.2, p=0.032), GRT (OR35.0,CI 2.0-617.3, p=0.015), combined buckle/PPV (OR37.7,CI 2.0-711.4, p=0.015), SO1000cs (OR86.6,CI 5.6-1,348.0), p=0.001) and 5000cs (OR37.2,CI 1.3-1,101.5, p=0.036) (Reference-tamponade:SF) were associated with unexplained visual loss. Duration of oil tamponade was not linked to increase in unexplained visual loss (p=0.569).
Correlation between SO in detachment repairs and unexplained visual loss has been established, however incidence with HSO has not been compared to other agents. This study demonstrates that although SO was linked with risk-adjusted increased unexplained visual loss relative to gas tamponade, no such association was found for Densiron, on multivariable analysis.
测量原发性孔源性视网膜脱离（RRD）修复术后不明原因和所有原因导致视力丧失的比例，比较气体填塞（SF、CF、CF）、硅油（SO，1000cs和5000cs）和重硅油（Densiron）。
对2017年1月1日至2021年5月31日进行回顾性、连续性、对比研究。所有原发性RRD在成功取出SO和Densiron后纳入研究。排除原发性失败病例。视力丧失定义为logMAR单位降低≥0.30。采用多变量二元逻辑回归和线性回归模型比较填塞物，并对所有不明原因视力丧失和logMAR增益病例进行分析。协变量包括年龄、眼部合并症、术前视力、黄斑状态、高度近视、巨大视网膜裂孔（GRT）、全氟碳使用情况、联合环扎/玻璃体切除术（PPV）、增殖性玻璃体视网膜病变C级（PVR-C）、视网膜切除术、填塞剂和术后晶状体状态。
在1012例原发性RRD中，我们发现不明原因视力丧失的发生率为15/1012（1.5%，SF：1/341[0.3%]，CF：4/338[1.2%]，CF：2/239[0.8%]，Densiron：0/33[0.0%]，SO-1000cs：5/43[11.6%]，SO-5000cs：3/18[16.7%]），所有原因导致视力丧失的发生率为57/1012（5.6%，SF：13/341[3.8%]，CF：14/338[4.1%]，CF：15/239[6.3%]，Densiron：2/33[6.1%]，SO-1000cs：9/43[20.9%]，SO-5千cs：4/18[22.2%]）。在多变量二元逻辑回归中，我们报告黄斑在位RRD（优势比[OR]5.7，95%置信区间[CI]1.2-28.2，p=0.032）、GRT（OR35.0，CI 2.0-617.3，p=0.015）、联合环扎/PPV（OR37.7，CI 2.0-711.4，p=0.015）、SO1000cs（OR86.6，CI 5.6-1,348.0，p=0.001）和5000cs（OR37.2，CI 1.3-1,101.5，p=0.036）（对照填塞物：SF）与不明原因视力丧失相关。硅油填塞时间与不明原因视力丧失增加无关（p=0.569）。
已证实视网膜脱离修复术中使用SO与不明原因视力丧失之间存在相关性，但尚未将重硅油与其他药物的发生率进行比较。本研究表明，虽然与气体填塞相比，SO与经风险调整后不明原因视力丧失增加有关，但在多变量分析中，未发现Densiron有此类关联。
