Lin Wei, Chen Hao, Ren Minxue, Lin Xiaoyan, Tang Yongping, Wei Yong
National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China .
Retina. 2025 May 1;45(5):863-870. doi: 10.1097/IAE.0000000000004374.
To investigate the surgical effect of complete drainage of suprachoroidal fluid before vitrectomy to avoid perioperative steroids in rhegmatogenous retinal detachment combined with choroidal detachment eyes.
It was a prospective, randomized controlled trial. Fifty-eight eyes were randomly divided into the no steroids (NS) group and local steroids (LS) group, 29 eyes each, respectively. Patients in the LS group received a single preoperative periocular injection of methylprednisolone, while suprachoroidal fluid drainage was performed before vitrectomy in eyes of the NS group. Follow-up assessments were performed at 1 week, 1 month, 3 months, and 6 months postoperatively.
The postoperative retinal reattachment rate was similar in the NS and LS groups (96.6% vs. 93.1%, P = 1.00). Best-corrected visual acuity was improved in 72.4% and 75.9% in the NS and LS groups, respectively. Inflammation occurred in five eyes (17.2%) in the NS group and six eyes (20.7%) in the LS group ( P = 0.74). Hypotony occurred in 11 (37.9%) and 14 eyes (48.3%) in the LS and NS groups ( P = 0.43), respectively. Macular chorioretinal folds were found in 21 (72.4%) and 22 eyes (75.9%) in the LS and NS groups ( P = 0.76), respectively. Hypotony and chorioretinal folds disappeared after 1 week postoperatively.
Preoperative steroids may not be necessary for rhegmatogenous retinal detachment combined with choroidal detachment patients if the suprachoroidal fluid is completely drained before vitrectomy. Postoperative retinal reattachment does not depend on the use of preoperative steroids; instead, surgeons should focus on improving surgical techniques in rhegmatogenous retinal detachment combined with choroidal detachment to improve the retinal reattachment rate.
探讨玻璃体切除术前行脉络膜上腔液体完全引流以避免孔源性视网膜脱离合并脉络膜脱离眼围手术期使用类固醇激素的手术效果。
这是一项前瞻性随机对照试验。58只眼被随机分为无类固醇激素组（NS组）和局部类固醇激素组（LS组），每组各29只眼。LS组患者术前接受一次球周注射甲泼尼龙，而NS组患者在玻璃体切除术前进行脉络膜上腔液体引流。术后1周、1个月、3个月和6个月进行随访评估。
NS组和LS组术后视网膜复位率相似（96.6%对93.1%，P = 1.00）。NS组和LS组最佳矫正视力分别提高了72.4%和75.9%。NS组有5只眼（17.2%）发生炎症，LS组有6只眼（20.7%）发生炎症（P = 0.7）。LS组和NS组分别有11只眼（37.9%）和14只眼（48.3%）发生低眼压（P = 0.43）。LS组和NS组分别有21只眼（72.4%）和22只眼（75.9%）出现黄斑部脉络膜视网膜皱褶（P = 0.76）。低眼压和脉络膜视网膜皱褶在术后1周后消失。
对于孔源性视网膜脱离合并脉络膜脱离的患者，如果在玻璃体切除术前脉络膜上腔液体完全引流，术前可能无需使用类固醇激素。术后视网膜复位并不依赖于术前使用类固醇激素；相反，外科医生应专注于提高孔源性视网膜脱离合并脉络膜脱离的手术技术以提高视网膜复位率。
