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玻璃体切割术后硅油相关黄斑囊样水肿的发生率及危险因素

Incidence of and Risk Factors for Silicone Oil-Associated Cystoid Macular Edema After Pars Plana Vitrectomy.

作者信息

Liu Jeffrey, Wirostko William, Ahmad Baseer

机构信息

School of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.

Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.

出版信息

J Vitreoretin Dis. 2025 Jun 26:24741264251345845. doi: 10.1177/24741264251345845.

Abstract

To observe the incidence of and risk factors for cystoid macular edema (CME) after silicone oil (SO) implantation after pars plana vitrectomy (PPV) for retinal detachment (RD) repair. This retrospective analysis used the TriNetX database to identify patients who received SO tamponade after PPV for RD between March 2014 and March 2023. The onset and regression of CME were identified using spectral-domain optical coherence tomography. The demographics, intraoperative parameters, and postoperative disease course of patients with and patients without CME were compared using χ tests, Student tests, and logistic regression models. Twenty (25.3%) of 79 eyes developed CME after intraocular insertion of SO. The use of 1000 cs SO (n = 50) vs 5000 cs SO (n = 29) was significantly associated with CME onset (odds ratio, 4.46; < .05). The mean (± SD) SO tamponade duration was 199.0 ± 125.5 days. The mean time from SO implantation to detection of CME was 82.6 ± 57.9 days. Disease regression occurred in 15 (75.0%) of the 20 eyes with CME and was recorded a mean of 218.2 ± 256.2 days after SO removal. Compared with untreated groups, the frequency of CME regression was not influenced by the administration of sub-Tenon triamcinolone acetonide (75.0% vs 75.0%; = 1.00), prednisolone acetate eyedrops (75.0% vs 75.0%; = 1.00), or ketorolac eyedrops (71.4% vs 76.9%; = .79). The viscosity of the SO used for vitreous tamponade in RD repair may play a role in the development of CME, with lighter grade oil increasing the risk for disease. Furthermore, SO removal alone potentially leads to a prominent reduction in CME in most cases.

摘要

观察视网膜脱离(RD)修复的玻璃体切割术(PPV)后硅油(SO)植入后黄斑囊样水肿(CME)的发生率及危险因素。这项回顾性分析使用TriNetX数据库识别2014年3月至2023年3月期间接受PPV治疗RD后行SO填塞的患者。使用光谱域光学相干断层扫描确定CME的发生和消退情况。使用χ检验、Student检验和逻辑回归模型比较有CME和无CME患者的人口统计学、术中参数和术后病程。79只眼中有20只(25.3%)在眼内植入SO后发生CME。使用1000厘沲SO(n = 50)与5000厘沲SO(n = 29)与CME发生显著相关(比值比,4.46;P <.05)。SO填塞的平均(±标准差)持续时间为199.0±125.5天。从SO植入到检测到CME的平均时间为82.6±57.9天。20只发生CME的眼中有15只(75.0%)病情消退,平均在SO取出后218.2±256.2天记录到病情消退。与未治疗组相比,CME消退频率不受球后注射曲安奈德(75.0%对75.0%;P = 1.00)、醋酸泼尼松龙滴眼液(75.0%对75.0%;P = 1.00)或酮咯酸滴眼液(71.4%对76.9%;P =.79)的影响。RD修复中用于玻璃体填塞的SO的粘度可能在CME的发生中起作用,较轻等级的油会增加患病风险。此外,在大多数情况下,仅取出SO可能会使CME显著减轻。

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本文引用的文献

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