Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China.
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
Int Ophthalmol. 2024 Nov 23;44(1):438. doi: 10.1007/s10792-024-03364-7.
This study aims to investigate the risk factors for postoperative vitreous cavity opacification following pars plana silicone oil removal and its impact on prognostic visual acuity.
A retrospective case-control study was conducted. A total of 66 eyes from 66 patients were enrolled in the study. On the first postoperative day, all patients underwent a scanning laser ophthalmoscopy to assess the turbidity of the vitreous cavity. 42.42% (28/66) were categorized as Grade 0, 36% (24/66) as Grade I, and 21% (14/66) as Grade II, based on the visibility of posterior pole blood vessels. Ordered multiple classification logistic regression analysis was employed to investigate the impact of surgical and baseline factors on the occurrence and severity of vitreous cavity opacification.
The presence of high myopia and the intraoperative combination of epiretinal membrane peeling exhibited significant correlations with the development of postoperative vitreous cavity opacification (OR = 3.424, 95% CI 2.326-31.643, P = 0.023; OR = 3.612, 95% CI 1.263-14.676, P = 0.031, respectively). The best corrected visual acuity (BCVA) on the first day post-surgery was significantly reduced across all degrees of opacification compared to the preoperative level (p < 0.001). However, no significant difference in BCVA was detected between the preoperative period, one-week post-operation, and the last follow-up (P > 0.05).
High myopia and intraoperative epiretinal membrane peeling may be associated with the development of more severe vitreous cavity opacity following silicone oil removal. This opacity generally resolves within one week post-surgery and does not appear to increase the risk of retinal re-detachment.
本研究旨在探讨硅油取出术后玻璃体混浊的危险因素及其对预后视力的影响。
采用回顾性病例对照研究。共纳入 66 例（66 只眼）患者。术后第 1 天，所有患者均行扫描激光检眼镜检查以评估玻璃体混浊程度。根据后极部血管的能见度，将 42.42%（28/66）的患者归为 0 级，36%（24/66）的患者归为 1 级，21%（14/66）的患者归为 2 级。采用有序多分类 Logistic 回归分析探讨手术和基线因素对玻璃体混浊发生和严重程度的影响。
高度近视和术中合并视网膜内界膜剥除与术后玻璃体混浊的发生显著相关（OR=3.424，95%CI 2.326-31.643，P=0.023；OR=3.612，95%CI 1.263-14.676，P=0.031）。与术前相比，所有混浊程度的术后第 1 天最佳矫正视力（BCVA）均显著降低（p<0.001）。然而，术前、术后 1 周和末次随访时的 BCVA 无显著差异（P>0.05）。
高度近视和术中视网膜内界膜剥除可能与硅油取出术后玻璃体混浊程度加重有关。这种混浊通常在术后 1 周内消退，且似乎不会增加视网膜再脱离的风险。
