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影响玻璃体视网膜手术后气体填塞持续时间的因素。

Factors affecting the duration of air tamponade following vitreoretinal surgery.

作者信息

Kaplan Fatih Bilgehan, Kerekli Cihan, Yakalı Onat, Açıkalın Banu

机构信息

Department of Ophthalmology, Kırklareli University, Kırklareli, Turkey.

Department of Ophthalmology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2025 Mar;263(3):727-733. doi: 10.1007/s00417-024-06696-3. Epub 2024 Nov 25.

Abstract

PURPOSE

Air as a tamponade in pars plana vitrectomy (PPV) is increasingly preferred due to its quick rehabilitation time. We aim to examine the factors affecting the absorption time of air tamponade.

METHOD

The study included 82 eyes from 78 patients who underwent PPV with air used as the tamponade. All patients underwent detailed ophthalmic examinations preoperatively and on the first and third postoperative days. The study evaluated demographic and clinical characteristics, surgical indications, and whether concurrent phacoemulsification surgery was performed. A single surgeon conducted all surgeries and examinations. The intraocular air percentage and volume in milliliters were determined. Patients were divided into two groups based on whether the intraocular air volume was reduced by more or less than 1.5 ml from the first to the third day.

RESULTS

Concurrent cataract surgery was performed in 35.4% of the eyes. All 82 eyes were pseudophakic at the end of the surgery. The mean air percentage in the eyes was 68.90% on the first day and 47.29% on the third day. Only the concurrent cataract surgery significantly shortened the air elimination time (p = 0.005). Other factors, such as diabetic retinopathy, glaucoma, and concurrent anti-VEGF therapy, did not show a significant impact.

CONCLUSION

The study concluded that concurrent cataract surgery notably reduces air tamponade duration after PPV. We think these findings are crucial for patient selection and surgical planning, especially in cases where maintaining a longer tamponade duration is critical, such as in retinal detachment or macular hole surgeries.

KEY MESSAGES

What is known The use of air as tamponade is becoming increasingly widespread in vitreoretinal surgery. What is new Compared to performing the surgeries separately, air tamponade shows faster absorption in concurrent cataract and vitreoretinal surgery. Factors such as diabetic retinopathy, glaucoma, and concurrent anti-VEGF therapy do not significantly affect the absorption time of intraocular air after vitreoretinal surgery.

摘要

目的

由于空气填充在平坦部玻璃体切除术(PPV)中的恢复时间快,其作为填塞物越来越受到青睐。我们旨在研究影响空气填塞吸收时间的因素。

方法

该研究纳入了78例接受PPV并使用空气作为填塞物的患者的82只眼睛。所有患者在术前以及术后第一天和第三天均接受了详细的眼科检查。该研究评估了人口统计学和临床特征、手术指征以及是否进行了同期白内障超声乳化手术。所有手术和检查均由同一位外科医生进行。确定眼内空气百分比和以毫升为单位的体积。根据眼内空气体积从第一天到第三天减少量是否大于或小于1.5毫升,将患者分为两组。

结果

35.4%的眼睛进行了同期白内障手术。所有82只眼睛在手术结束时均为人工晶状体眼。眼睛中的平均空气百分比在第一天为68.90%,在第三天为47.29%。只有同期白内障手术显著缩短了空气消除时间(p = 0.005)。其他因素,如糖尿病视网膜病变、青光眼和同期抗VEGF治疗,均未显示出显著影响。

结论

该研究得出结论,同期白内障手术显著缩短了PPV后空气填塞的持续时间。我们认为这些发现对于患者选择和手术规划至关重要,尤其是在维持较长填塞持续时间至关重要的情况下,如视网膜脱离或黄斑裂孔手术。

关键信息

已知情况:空气作为填塞物在玻璃体视网膜手术中的应用越来越广泛。新发现:与单独进行手术相比,空气填塞在同期白内障和玻璃体视网膜手术中吸收更快。糖尿病视网膜病变、青光眼和同期抗VEGF治疗等因素对玻璃体视网膜手术后眼内空气的吸收时间没有显著影响。

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