全氟碳液体与视网膜后切开术作为辅助手段在玻璃体切割术治疗孔源性视网膜脱离手术修复中的效果：一项随机临床试验。
Outcomes of perfluorocarbon liquid vs. posterior retinotomy as adjuncts during pars-plana vitrectomy for the surgical repair of rhegmatogenous retinal detachment: a randomized clinical trial.
作者信息
Mohamed Elsayed Saad Ehab, Elbadry Mohammed Mohammed Hazem, Mohamed-Aly Ibrahim Mohamed, Hassan Salama Selim Omar, Mostafa Elsayed Abdelhafeez Sayed, Mohammed Sakr Ahmed, Mohamed Abo Elftouh Elsalhy Fathy, Abdelmohsen Ali Ayoub Ahmed, Abdelsamea Alazab Ehab, Tharwat Ehab, Gamal El Sayed Mostafa Tamer
机构信息
Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt.
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
出版信息
BMC Ophthalmol. 2025 Aug 19;25(1):476. doi: 10.1186/s12886-025-04271-w.
PURPOSE
Rhegmatogenous retinal detachment (RRD) is a sight-threatening condition requiring prompt surgical intervention. Various adjunctive techniques are employed to enhance subretinal fluid drainage and retinal reattachment. This study aimed to evaluate the outcomes of perfluorocarbon liquid (PFCL) versus posterior retinotomy (PR) during pars plana vitrectomy (PPV) for RRD, focusing on anatomical success, visual acuity, intraocular pressure (IOP), and complications.
METHODS
This is a prospective randomized controlled trial that included 58 eyes with RRD, divided into Group A (PFCL, n = 29) and Group B (PR, n = 29). Preoperative assessments included best-corrected visual acuity (BCVA), IOP, axial length, lens status, macula status, and PVR grade. Outcomes were evaluated at 1 week, 1 month, 2 months, and 3 months postoperatively. Primary outcomes included retinal reattachment rates and the number of operations; secondary outcomes included BCVA, IOP changes, complications like cataract development, retinal redetachment, epiretinal membrane (ERM) formation, and single-surgery success.
RESULTS
Retinal reattachment rates were comparable (76% in Group A vs. 66% in Group B, p = 0.387), as well as the number of operations (p = 0.375). Moreover, BCVA improved significantly in both groups (p < 0.05), with no intergroup differences. IOP increased postoperatively in both groups (p < 0.001), with no significant differences. No differences were observed in cataract formation or retinal redetachment. However, ERM incidence was significantly higher in the PR group (27% vs. 11%, p = 0.049).
CONCLUSION
PFCL and PR are effective for RRD repair, with similar anatomical and visual outcomes. However, PFCL may reduce ERM risk, making it preferable in certain cases. These findings guide surgical decision-making and highlight the need for further research.
TRIAL REGISTRATION
The study was retrospectively registered at ClinicalTrials.gov (NCT06919211) on April 4, 2025.
目的
孔源性视网膜脱离（RRD）是一种威胁视力的疾病，需要及时进行手术干预。人们采用了各种辅助技术来促进视网膜下液引流和视网膜复位。本研究旨在评估在玻璃体视网膜手术（PPV）治疗RRD过程中，全氟碳液（PFCL）与视网膜后切开术（PR）的治疗效果，重点关注解剖学成功率、视力、眼压（IOP）及并发症。
方法
这是一项前瞻性随机对照试验，纳入了58例RRD患者的眼睛，分为A组（PFCL，n = 29）和B组（PR，n = 29）。术前评估包括最佳矫正视力（BCVA）、IOP、眼轴长度、晶状体状态、黄斑状态和增殖性玻璃体视网膜病变（PVR）分级。在术后1周、1个月、2个月和3个月对治疗效果进行评估。主要指标包括视网膜复位率和手术次数；次要指标包括BCVA、IOP变化、白内障形成、视网膜再脱离、视网膜前膜（ERM）形成等并发症以及单次手术成功率。
结果
视网膜复位率相当（A组为76%，B组为66%，p = 0.387），手术次数也相当（p = 0.375）。此外，两组的BCVA均显著改善（p < 0.05），组间无差异。两组术后IOP均升高（p < 0.001），无显著差异。在白内障形成或视网膜再脱离方面未观察到差异。然而，PR组的ERM发生率显著更高（27%对11%，p = 0.049）。
结论
PFCL和PR对RRD修复有效，在解剖学和视力方面的效果相似。然而，PFCL可能降低ERM风险，在某些情况下更具优势。这些发现为手术决策提供了指导，并凸显了进一步研究的必要性。
试验注册
该研究于2025年4月4日在ClinicalTrials.gov（NCT06919211）进行了回顾性注册。
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