Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Ophthalmology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea.
Arq Bras Oftalmol. 2024 Mar 4;87(2):e20220334. doi: 10.5935/0004-2749.2022-0334. eCollection 2024.
This study aimed to evaluate the efficacy and clinical outcomes of a one-way fluid-air exchange procedure for the treatment of postvitrectomy diabetic vitreous hemorrhage in patients with proliferative diabetic retinopathy.
This retrospective study included 233 patients with proliferative diabetic retinopathy, who underwent vitrectomy. A one-way fluid-air exchange procedure was performed in 24 eyes of 24 (10.30%) patients with persistent vitreous cavity rebleeding after the operation. Preprocedural and postprocedural best-corrected visual acuity values were achieved. Complications occurring during and after the procedure were analyzed.
Significant visual improvement was observed 1 month after the one-way fluid-air exchange procedure (2.62 ± 0.60 LogMAR at baseline vs. 0.85 ± 0.94 LogMAR at postprocedure, p<0.0001). Moreover, 19 (79.17%) eyes needed the procedure once, and 5 (20.83%) eyed had the procedure more than twice. In 3 (12.50%) eyes, reoperation was eventually required because of persistent rebleeding despite several fluid-air exchanges. No complication was observed during the follow-up.
The one-way fluid-air exchange procedure can be an excellent alternative to re-vitrectomy for patients with proliferative diabetic retinopathy suffering from postvitrectomy diabetic vitreous hemorrhage by removing the hemorrhagic contents directly and achieving fast recovery of visual function without apparent complications.
本研究旨在评估单向液-气交换程序治疗增生性糖尿病视网膜病变患者玻璃体切割术后糖尿病性玻璃体积血的疗效和临床结果。
本回顾性研究纳入了 233 例接受玻璃体切割术的增生性糖尿病视网膜病变患者。对 24 例（10.30%）患者的 24 只眼在手术后持续发生玻璃体腔再出血的患者进行单向液-气交换程序。评估术前和术后最佳矫正视力值。分析术中及术后发生的并发症。
单向液-气交换程序 1 个月后观察到显著的视力改善（基线时为 2.62±0.60 LogMAR，术后为 0.85±0.94 LogMAR，p<0.0001）。此外，19 只（79.17%）眼需要进行一次该程序，5 只（20.83%）眼需要进行两次以上该程序。在 3 只（12.50%）眼中，尽管进行了多次液-气交换，但由于持续再出血，最终仍需要再次手术。在随访期间未观察到任何并发症。
单向液-气交换程序可作为增生性糖尿病视网膜病变患者玻璃体切割术后糖尿病性玻璃体积血的一种极好替代治疗方法，通过直接清除出血内容物，快速恢复视力功能，且无明显并发症。
