硅油取出术后视网膜再次脱离：风险因素分析。

Retinal redetachment after silicone oil removal: a risk factor analysis.

机构信息

Department of Ophthalmology, University Hospital of Nancy, Rue du Morvan, Vandoeuvre-les-Nancy, 54500, France.

UMR Inserm U1256 NGERE (Nutrition-Genetics and Exposure to Environmental Risks), Université de Lorraine, Nancy, France.

出版信息

BMC Ophthalmol. 2024 Aug 15;24(1):346. doi: 10.1186/s12886-024-03618-z.

DOI:10.1186/s12886-024-03618-z

PMID:39148018

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11325823/

Abstract

PURPOSE

To report the rate of retinal redetachment after silicone oil removal following rhegmatogenous retinal detachment surgery and to determine potential risk factors.

METHODS

Retrospective observational case series of 161 eyes who underwent rhegmatogenous retinal detachment surgery and subsequent silicone oil removal. Pre- and intraoperative risk factors were evaluated using univariate and multivariate logistic regression. We also evaluated the effect of tamponade duration on anatomical outcomes.

RESULTS

The median tamponade duration was 5.9 [4.3;7.6] months. Seventeen (10.6%) eyes underwent silicone oil removal within 3 months of surgery, with a median delay of 2.3 [2.0;2.8] months. The rate of retinal detachment after silicone oil removal was 14.9%. A history of previous unsuccessful surgery was the only significant risk factor for retinal redetachment after silicone oil removal (OR 4.8, 95%CI [1.5;19.0], p = 0.02). The use of 360° laser retinopexy and concomitant air or gas tamponade during silicone oil removal were not found to affect the redetachment rate. Eyes with silicone oil tamponade ≤ 3 months showed an increased, albeit not significant, risk of developing recurrent rhegmatogenous retinal detachment after silicone oil removal (35.3% versus 12.5%, p = 0.06).

CONCLUSION

A retinal redetachment occurred in 14.9% of eyes undergoing silicone oil removal following rhegmatogenous retinal detachment surgery. Previous failed surgery was associated with a 4.8-fold increased risk of developing recurrent rhegmatogenous retinal detachment after silicone oil removal. Eyes with silicone oil tamponade ≤ 3 months tended to have a higher redetachment rate.

TRIAL REGISTRATION NUMBER

ID NCT05647928 (12th April 2022).

摘要

目的

报告孔源性视网膜脱离手术后硅油取出后视网膜再脱离的发生率，并确定潜在的危险因素。

方法

对 161 例接受孔源性视网膜脱离手术和随后硅油取出的患者进行回顾性观察性病例系列研究。使用单变量和多变量逻辑回归评估术前和术中的危险因素。我们还评估了填塞时间对解剖结果的影响。

结果

中位填塞时间为 5.9 [4.3；7.6] 个月。17 只（10.6%）眼在手术后 3 个月内行硅油取出术，中位延迟时间为 2.3 [2.0；2.8] 个月。硅油取出后视网膜脱离的发生率为 14.9%。既往手术失败史是硅油取出后视网膜再脱离的唯一显著危险因素（OR 4.8，95%CI [1.5；19.0]，p=0.02）。360°激光视网膜光凝术的应用和硅油取出时同时使用空气或气体填塞并未发现对再脱离率有影响。硅油填塞时间≤3 个月的眼硅油取出后发生复发性孔源性视网膜脱离的风险增加，尽管无统计学意义（35.3%对 12.5%，p=0.06）。