Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
National Clinical Research Center for Eye Diseases, Shanghai, China.
Transl Vis Sci Technol. 2024 Sep 3;13(9):16. doi: 10.1167/tvst.13.9.16.
With the widespread application of silicone oil in vitreoretinal surgery, the purpose of this study was to determine the risk factors of long-term vision loss 12 months post oil removal in retina-detached eyes treated with vitrectomy and silicone oil tamponade.
Of the 592 patients approached, eligible eyes completed the investigation up to 12 months post-oil-removal. Eligible eyes underwent pars-plana vitrectomy following oil tamponade. Oil removal was performed after 3 to 28 months in different individuals, under the condition that the retina has reattached as well as the hemorrhage and inflammation has dissolved. Postoperative best-corrected visual acuity (BCVA), age, sex, and interval between tamponade and removal were recorded, and retinal thickness was determined using optical coherence tomography (OCT).
Fifty eyes of 50 participants aged 31 to 83 years were enrolled. BCVA (LogMAR) 12 months post-oil-removal improved in 25 of 40 (62.5%) patients, varying from 0.05 (20/22) to 1.0 (20/200) (mean ± SD = 0.55 ± 0.32). Pre-oil-removal nasal perifoveal retinal nerve fiber layer thickness varied from 16 to 83 µm (38.40 ± 18.50), and was significantly linked with post-oil-removal BCVA (0.5%, 95% confidence interval 0.0%-1.0%; P = 0.046).
This study demonstrates the risk factors and prognosis of visual function after long-term regeneration post vitrectomy, oil tamponade, and oil removal, thereby underscoring the need for a complete, dynamic examination of retinal structure via OCT measurement. Related studies should be conducted on a larger scale to facilitate the stratification of late-period vision damage in retina-detached eyes.
This study developed OCT-based clinical markers for the postoperative visual prognosis of eyes affected by retinal detachment.
随着硅油在眼后段玻璃体视网膜手术中的广泛应用，本研究旨在确定接受玻璃体切割联合硅油填充术治疗的视网膜脱离眼硅油取出后 12 个月视力丧失的危险因素。
对 592 例患者进行评估，符合条件的眼在硅油取出后完成了 12 个月的随访。符合条件的眼行硅油填充眼玻璃体切割术。不同个体的硅油取出时间为 3 至 28 个月，视网膜复位、出血和炎症溶解后进行。记录术后最佳矫正视力（BCVA）、年龄、性别和填充与取出之间的时间间隔，并使用光学相干断层扫描（OCT）测量视网膜厚度。
共纳入 50 例 50 只眼，年龄 31 至 83 岁。40 例（62.5%）患者在硅油取出后 12 个月时 BCVA（LogMAR）提高，从 0.05（22/200）提高到 1.0（20/20）（均值±标准差=0.55±0.32）。硅油取出前鼻侧黄斑区神经纤维层厚度为 16 至 83µm（38.40±18.50），与硅油取出后 BCVA 显著相关（0.5%，95%置信区间 0.0%-1.0%；P=0.046）。
本研究表明了玻璃体切割联合硅油填充和硅油取出术后长期视网膜再生的视力预后的危险因素，强调需要通过 OCT 测量对视网膜结构进行全面、动态的检查。应开展更大规模的相关研究，以利于对视网膜脱离眼晚期视力损害进行分层。
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