Department of Ophthalmology, University Hospital of Strasbourg, Strasbourg, France.
Department of Clinical Investigation, University Hospital of Strasbourg, Strasbourg, France.
Retina. 2024 Nov 1;44(11):1891-1898. doi: 10.1097/IAE.0000000000004220.
To compare two drainage techniques in macula-off retinal detachment surgery: perfluorocarbon liquid (PFCL)-assisted drainage and partial subretinal fluid drainage without PFCL. This study investigated morphological and functional outcomes, focusing on metamorphopsia quantification.
Eighty eyes with macula-off retinal detachment were retrospectively included. All underwent a 25-gauge pars plana vitrectomy. In the PFCL group, subretinal fluid drainage was performed using PFCL. In the partial subretinal fluid drainage (SRFD) group, subretinal fluid was partially drained through a preexisting retinal break without PFCL. A follow-up at 3 months and 6 months evaluated anatomical outcomes using optical coherence tomography, best-corrected visual acuity, and metamorphopsia quantified with M-charts.
Reattachment rates were comparable in the PFCL group (97.5%) and the SRFD group (95%) ( P > 0.05). Mean best-corrected visual acuity (logMAR) was 0.23 ± 0.32 (PFCL group) and 0.15 ± 0.13 (SRFD group) ( P = 0.206). Metamorphopsia was reported by 19 patients (47.5%) in the PFCL group and by 12 patients (30%) in the SRFD group ( P = 0.332). The mean metamorphopsia score was similar in both groups (0.27 ± 0.12 in the PFCL group and 0.28 ± 0.11 in the SRFD group, P = 0.866). Morphological optical coherence tomography findings were comparable in both groups.
Morphological and functional outcomes were similar in PFCL and SRFD groups. Metamorphopsia quantification scores did not improve with PFCL. While both of these techniques might be effective and could be recommended for primary macula-off retinal detachment management, potential PFCL toxicity should be kept in mind and its use dedicated to selected cases.
比较两种黄斑下视网膜脱离手术中的引流技术：全氟碳液体（PFCL）辅助引流和无 PFCL 的部分视网膜下液引流。本研究主要关注并量化了变形性视症，调查了形态和功能的结果。
回顾性纳入 80 只黄斑下视网膜脱离的眼睛。所有患者均接受 25G 经睫状体平坦部玻璃体切除术。在 PFCL 组中，使用 PFCL 进行视网膜下液引流。在部分视网膜下液引流（SRFD）组中，通过预先存在的视网膜裂孔部分排出视网膜下液，而不使用 PFCL。术后 3 个月和 6 个月，使用光学相干断层扫描（OCT）评估解剖学结果，使用最佳矫正视力（BCVA）和 M 图量化的变形性视症。
PFCL 组（97.5%）和 SRFD 组（95%）的再附着率相当（P＞0.05）。平均 BCVA（logMAR）分别为 0.23±0.32（PFCL 组）和 0.15±0.13（SRFD 组）（P=0.206）。PFCL 组有 19 例（47.5%）患者报告有变形性视症，SRFD 组有 12 例（30%）患者报告有变形性视症（P=0.332）。两组的平均变形性视症评分相似（PFCL 组为 0.27±0.12，SRFD 组为 0.28±0.11，P=0.866）。两组的形态学 OCT 检查结果相似。
PFCL 组和 SRFD 组的形态和功能结果相似。PFCL 并未改善变形性视症的量化评分。虽然这两种技术都可能有效，并可推荐用于原发性黄斑下视网膜脱离的治疗，但应注意潜在的 PFCL 毒性，并将其应用于选定的病例。
