Efficacy and impacts of air tamponade combined with vitrectomy in the treatment of rhegmatogenous retinal detachment
10.3760/cma.j.cn511434-20200211-00049
- VernacularTitle:空气填充在孔源性视网膜脱离玻璃体切割手术中的临床应用及影响因素分析
- Author:
Ying YU
1
;
Lun ZENG
;
Zhongkai YANG
;
Rongrong ZHU
;
Shengding XUE
;
Hui CHEN
Author Information
1. 南通大学附属医院眼科 226001
- From:
Chinese Journal of Ocular Fundus Diseases
2020;36(8):605-610
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and impacts of air tamponadein treating rhegmatogenous retinal detachments (RRD) including inferior breaks after 25G pars plana vitrectomy (PPV).Methods:A prospective non-randomized study. From November 2016 to December 2018, 110 RRD patients receiving PPV in the Ophthalmology Department of Affiliated Hospital of Nantong University were included in the study. All the patients choose the operation mode voluntarily after fully understand the condition and operation mode. There were 90 eyes in the air filling group and 20 eyes in the silicone oil filling group. There was no difference of age ( t=-0.082), sex ratio ( χ2=1.538), left or right eye ( χ2=0.839), average course of disease ( Z=-0.276), intraocular pressure ( t=3.669), axial length ( t=0.765), grade of proliferative vitreous retinopathy ( Z=-2.101), high myopia ( χ2=0.013), lens state ( χ2=1.275), logMAR BCVA ( t=-0.681), the scope of retinal detachment ( t=0.970), the site ( χ2=0.108) and numbers ( t=0.158) of the retinal holes, whether involving macula ( χ2=1.791) between the two groups ( P>0.05). At 1, 3, and 6 months after surgery, the first retinal reduction rate, BCVA increase rate, visual recovery rate, intraocular pressure, fovea retinal thickness (CFT), ellipsoid and cross sectional area, and the occurrence of postoperative complications in the two groups were observed and compared. Independent sample t test and Chi-squared test, Mann-Whitney U test, and ANOVA were used for data comparision. Results:After the first operation, retinal reattachmnents were achieved in 87 eyes (96.6%) in the air group and 19 eyes (95.0%) in the silicone oil group ( χ2=0.130, P>0.05). In the air group and the silicone oil group, there were 7 and 2 eyes with subretinal holes, whose retinal reattachmnents were achieved. At 6 months after surgery, logMAR BCVA of the eyes in the air group and the silicone oil group were 0.23±0.23 and 0.37±0.23, respectively. All of them were higher than that before operation ( t=-2.410, P<0.001). BCVA in the air group was superior to that in the silicone oil group ( P<0.05). The increase rate of BCVA of the eyes in the air group and the silicone oil group were 0.69±0.28 and 0.48±0.30 logMAR units, respectively ( t=-3.225, P<0.05). The CFT of the eyes in the air group and the silicone oil group were 226.87±42.30 μm and 234.83±36.10 μm, respectively ( t=-0.448, P=0.657). In the air group and silicone oil group, posterior cataract was observed in 15 and 4 eyes, subretinal residual fluid in 1 and 2 eyes, and visual object deformation in 3 eyes respectively. In the air group and silicone oil group, posterior cataract was observed in 15 and 4 eyes, subretinal residual fluid in 1 and 2 eyes, and visual object deformation in 3 eyes respectively. Conclusions:Air filling combined with PPV can effectively treat RRD, which is suitable for both superior and inferior holes. The visual acuity recovered well and the complication is less. The time of retinal detachment (especially the time of macular detachment) is an important factor affecting the prognosis.
