Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Medicine (Baltimore). 2023 Oct 27;102(43):e35546. doi: 10.1097/MD.0000000000035546.
The effectiveness of filtered air tamponade for superior retinal breaks was well established. This study was performed to compare the treatment efficacy of pars plana vitrectomies (PPV) with filtered air and silicone oil (SO) for patients with rhegmatogenous retinal detachment (RRD) caused by superior breaks with no or mild proliferative vitreoretinopathy. Patients of RRD with superior breaks who underwent PPV with filtered air (Group A) and SO (Group S) tamponade were reviewed retrospectively. Age, gender, laterality, lens status, duration of symptoms, macular status, proliferative vitreoretinopathy grade, use of perfluorocarbon liquid, early and late postoperative complications, follow-up duration were acquired. The primary anatomic reattachment after the first surgery and the final rate of successful reattachment was compared as the main outcome. Secondary outcomes were long-term postoperative best-corrected visual acuity (BCVA), rate of deferred cataract removal, surgical complications and total surgery number. The primary anatomic success rate was 88% (14/16 eyes) in Group A and 100% (16/16 eyes) in group S, which was not significantly different (P = .484). Both groups achieved 100% final anatomic success. The rate of cataract removal was 57.1% and 100% (P = .016), and the duration from first surgery to cataract surgery was 231.38 ± 241.23 and 156.36 ± 110.09 days (P = .428) for group A and group S, respectively. The rate of postoperative epiretinal membrane was 21.4% vs 25.0% (P = 1.000). Postoperative BCVA was associated with preoperative BCVA after multiple linear analysis. The primary and final anatomic success rate for PPV with air tamponade and SO in treating RRD with superior breaks were not statistically different. The rate of deferred cataract removal was higher in patients with SO as tamponade.
过滤空气填充治疗上方视网膜裂孔的效果已得到充分证实。本研究旨在比较合并无或轻度增生性玻璃体视网膜病变的上方裂孔性孔源性视网膜脱离（RRD）患者行巩膜扣带术联合过滤空气和硅油填充（SO）与单纯行巩膜扣带术联合过滤空气治疗的效果。回顾性分析了行巩膜扣带术联合过滤空气（A 组）和 SO 填充（S 组）治疗上方裂孔性 RRD 的患者，比较两组患者的年龄、性别、眼别、晶状体状态、症状持续时间、黄斑状态、增生性玻璃体视网膜病变分级、使用全氟碳液体、术后早期和晚期并发症、随访时间。主要观察指标为首次手术后的主要解剖复位率和最终总复位率。次要观察指标为长期术后最佳矫正视力（BCVA）、延期白内障手术率、手术并发症和总手术次数。A 组初次手术的解剖复位率为 88%（14/16 眼），S 组为 100%（16/16 眼），差异无统计学意义（P=0.484）。两组最终的解剖复位率均为 100%。白内障手术率分别为 57.1%和 100%（P=0.016），A 组和 S 组从初次手术到白内障手术的时间分别为 231.38±241.23 天和 156.36±110.09 天（P=0.428）。术后视网膜内膜发生率分别为 21.4%和 25.0%（P=1.000）。多线性分析显示，术后 BCVA 与术前 BCVA 相关。巩膜扣带术联合过滤空气填充和 SO 治疗上方裂孔性 RRD 的初次手术和最终解剖复位率无统计学差异。SO 作为填充物的患者白内障延迟切除率更高。
