Abdi Fatemeh, Zand Amin, Mirzakhan Mohammad, Zarehosseinabadi Vahid, Anvari Pasha, Mirshahi Reza, Sedaghat Ahad, Taherian Mohammad Mahdi, Gordiz Arzhang, Alemzadeh Sayyed Amirpooya
Eye Research Center, Eye Department, The Five Senses Health Institute, Rassoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.
Eur J Ophthalmol. 2025 May;35(3):1091-1097. doi: 10.1177/11206721241286123. Epub 2024 Sep 19.
PurposeTo compare the occurrence and characteristics of retinal displacement following direct perfluorocarbon liquid (PFCL)-silicone oil (SO) exchange versus indirect PFCL for air and air for SO exchange methods during pars plana vitrectomy (PPV) in patients with rhegmatogenous retinal detachment (RRD).MethodsA comparative case series study was conducted on 58 eyes with recent RRD, undergoing standard three-port PPV with SO tamponade. Fluid exchange was performed using either direct or indirect methods. Postoperatively, a comprehensive ophthalmic examination and fundus autofluorescence (FAF) imaging were conducted at one month. The presence, amount, and direction of retinal displacement were assessed based on FAF imaging and compared between the direct and indirect fluid exchange groups.ResultsFAF imaging at one month revealed retinal displacement in 41.4% of eyes in the direct group and 62.1% in the indirect group, with no statistical difference between them (= 0.537). However, the mean displacement was significantly higher in the indirect group (282.61 ± 110.83 µm) compared to the direct group (220.33 ± 39.67 µm, = 0.04). The direction of displacement (downward or upward) did not differ significantly between the groups (= 0.093).ConclusionsWhile the occurrence and location of postoperative retinal displacement did not significantly differ between direct and indirect fluid exchange methods during PPV for RRD, eyes treated with the direct method exhibited lower mean displacement compared to the indirect method. These findings suggest potential benefits of the direct exchange approach in minimizing retinal displacement following surgery.
目的
比较孔源性视网膜脱离（RRD）患者在玻璃体切割术（PPV）期间直接全氟碳液体（PFCL）-硅油（SO）置换与间接PFCL置换空气及空气置换SO方法后视网膜移位的发生率及特征。
方法
对58例近期发生RRD的患眼进行了一项比较性病例系列研究，这些患眼均接受了标准三通道PPV及SO填塞术。采用直接或间接方法进行液体置换。术后1个月进行全面的眼科检查及眼底自发荧光（FAF）成像。根据FAF成像评估视网膜移位的存在、程度及方向，并在直接和间接液体置换组之间进行比较。
结果
1个月时的FAF成像显示，直接组41.4%的患眼出现视网膜移位，间接组为62.1%，两组之间无统计学差异（P = 0.537）。然而，间接组的平均移位（282.61±110.83 µm）显著高于直接组（220.33±39.67 µm，P = 0.04）。两组之间移位方向（向下或向上）无显著差异（P = 0.093）。
结论
虽然RRD患者在PPV期间直接和间接液体置换方法术后视网膜移位的发生率及位置无显著差异，但与间接方法相比，直接方法治疗的患眼平均移位较低。这些发现提示直接置换方法在减少术后视网膜移位方面可能具有潜在益处。
