ElSheikh Reem H, Zhang Sairi, Chauhan Muhammad Z, Sanders Riley N, Uwaydat Sami H
Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot # 523, Little Rock, AR, 72205, USA.
College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Int J Retina Vitreous. 2024 Sep 12;10(1):64. doi: 10.1186/s40942-024-00582-0.
Cystoid macular edema (CME) can develop following silicone oil placement in complex vitreoretinal surgeries, contributing to poor visual outcomes. In this study, we investigated the clinical and surgical characteristics associated with the development of CME following the use of silicone oil (SO) in pars plana vitrectomy (PPV) surgeries.
We conducted a retrospective chart review of patients who underwent implantation of SO during PPV from 2010 to 2020 by a single surgeon. Patient demographics, type of oil, duration of oil tamponade, retinectomy size, diabetic status, lens status, prior panretinal photocoagulation, visual acuity, and incidence of CME were reviewed.
This study included 43 eyes from 40 patients who underwent SO tamponade for retinal detachment (RD) surgery. The mean duration of SO tamponade was 15.7 ± 12.7 months (range: 1-58 months). The most common indication for surgery was diabetic tractional RD (32.7%), followed by traumatic RD (16.3%) and rhegmatogenous RD with proliferative vitreoretinopathy (11.6%). Of the 43 eyes, 18 (41.9%) developed CME for the first time after PPV with SO placement, with 8 (44%) resolving within a year of oil removal. The mean duration for the development of CME was 9 months. A logistic regression model showed that a scleral buckle procedure and poor initial vision were statistically significant factors for predicting the development of CME (ORs: 11.65 and 16.06, respectively). Overall, 91% of the patients had stable or improved vision after surgery.
The use of a scleral buckle procedure and poor initial vision are significant factors for predicting CME following silicone oil tamponade in PPV surgeries, with 41.9% of patients developing CME with an average duration of 9 months. Recognizing such factors can lead to early monitoring and prompt management of CME.
Partial analyses were presented at the ASRS 2020 conference.
Not applicable.
在复杂的玻璃体视网膜手术中注入硅油后可发生黄斑囊样水肿（CME），导致视力预后不佳。在本研究中，我们调查了在玻璃体切除联合硅油（SO）填充的扁平部玻璃体切除术（PPV）后发生CME的临床和手术相关特征。
我们对2010年至2020年间由同一位外科医生进行PPV并植入SO的患者进行了回顾性病历审查。回顾了患者的人口统计学资料、硅油类型、硅油填充时间、视网膜切除术范围、糖尿病状态、晶状体状态、既往全视网膜光凝、视力以及CME的发生率。
本研究纳入了40例接受SO填充治疗视网膜脱离（RD）手术的43只眼。SO填充的平均时间为15.7±12.7个月（范围：1 - 58个月）。最常见的手术适应证是糖尿病性牵拉性RD（32.7%），其次是外伤性RD（16.3%）和伴有增殖性玻璃体视网膜病变的孔源性RD（11.6%）。在这43只眼中，18只（41.9%）在PPV联合SO填充后首次发生CME，其中8只（44%）在硅油取出后一年内消退。CME发生的平均时间为9个月。逻辑回归模型显示，巩膜扣带术和初始视力差是预测CME发生的统计学显著因素（OR分别为11.65和16.06）。总体而言，91%的患者术后视力稳定或提高。
巩膜扣带术和初始视力差是PPV手术中硅油填充后预测CME的重要因素，41.9%的患者发生CME，平均持续时间为9个月。认识到这些因素有助于对CME进行早期监测和及时处理。
部分分析结果在2020年美国视网膜专家协会（ASRS）会议上进行了展示。
不适用
