目的:测量原发性孔源性视网膜脱离(RRD)修复后视力丧失的原因不明和所有原因的比例,比较气体填塞(SF6,C2F6,C3F8),硅油(SO,1000cs和5000cs)和重硅油(Densiron)。
方法:回顾性,连续,2017-01-2021-31/5比较研究。成功去除SO和Densiron后,包括所有主要RRD。主要故障已排除。视力丧失定义为降低≥0.30logMAR单位。多变量二元逻辑和线性回归模型来比较填塞,并进行了所有无法解释的视力丧失和logMAR增加的病例。协变量包括年龄,眼部合并症,术前视野,黄斑状态,高度近视,巨大视网膜撕裂(GRT),全氟化碳用途,组合带扣/PPV,PVR-C,视网膜切除术,填塞剂和术后晶状体状态。
结果:在1,012个主RRD中,我们在15/1012发现了无法解释的视力丧失的发生率(1.5%,SF6:1/341[0.3%],C2F6:4/338[1.2%],C3F8:2/239[0.8%],Densiron:0/33[0.0%],SO-1000cs:5/43[11.6%]和SO-5000cs:3/18[16.7%]),和所有原因的视力丧失在57/1012(5.6%,SF6:13/341[3.8%],C2F6:14/338[4.1%],C3F8:15/239[6.3%],Densiron:2/33[6.1%],SO-1000cs:9/43[20.9%]和SO-5000cs:4/18[22.2%])。在多变量二元逻辑回归中,我们报告黄斑上RRD(赔率比[OR]5.7,95%置信区间[CI]1.2-28.2,p=0.032),GRT(OR35.0,CI2.0-617.3,p=0.015),组合带扣/PPV(OR37.7,CI2.0-711.4,p=0.015),SO1000cs(OR86.6,CI5.6-1,348.0),p=0.001)和5000cs(OR37.2,CI1.3-1,101.5,p=0.036)(参考填塞:SF6)与无法解释的视力丧失有关。油填塞的持续时间与无法解释的视力丧失的增加无关(p=0.569)。
结论:已经确定了脱离修复中的SO与无法解释的视力丧失之间的相关性,然而,HSO的发病率尚未与其他药物进行比较。这项研究表明,尽管相对于气体填塞,SO与风险调整后的无法解释的视力丧失增加有关,没有发现Densiron有这样的关联,关于多变量分析。
OBJECTIVE: To measure the proportion of unexplained and all causes of visual loss following primary rhegmatogenous-retinal-detachment (RRD) repair, comparing gas tamponade (SF6, C2F6, C3F8), silicone oil (SO, 1000cs and 5000cs) and heavy silicone oil (Densiron).
METHODS: Retrospective, continuous, comparative study from 01/1/2017-31/5/2021. All primary RRDs were included after successful removal of SO and Densiron. Primary failures were excluded. Visual loss was defined as reduction of ≥0.30 logMAR units. Multivariable binary-logistic and linear regression models to compare tamponade, and all cases of unexplained visual loss and logMAR gain were performed. Covariates included age, ocular co-morbidities, pre-op vision, macula-status, high-myopia, giant-retinal-tear (GRT), perfluorocarbon-use, combined buckle/PPV, PVR-C, retinectomy, tamponade agent and post-operative lens status.
RESULTS: Of 1,012 primary RRDs, we found an incidence of unexplained visual loss in 15/1012 (1.5%, SF6:1/341[0.3%], C2F6:4/338[1.2%], C3F8:2/239[0.8%], Densiron:0/33[0.0%], SO-1000cs:5/43[11.6%] and SO-5000cs:3/18[16.7%]), and visual loss of all causes in 57/1012 (5.6%, SF6:13/341[3.8%], C2F6:14/338[4.1%], C3F8:15/239[6.3%], Densiron:2/33[6.1%], SO-1000cs:9/43[20.9%] and SO-5000cs:4/18[22.2%]). On multivariable binary-logistic regression, we report that macula-on RRD (Odds-Ratio[OR]5.7,95% Confidence-interval[CI]1.2-28.2, p=0.032), GRT (OR35.0,CI 2.0-617.3, p=0.015), combined buckle/PPV (OR37.7,CI 2.0-711.4, p=0.015), SO1000cs (OR86.6,CI 5.6-1,348.0), p=0.001) and 5000cs (OR37.2,CI 1.3-1,101.5, p=0.036) (Reference-tamponade:SF6) were associated with unexplained visual loss. Duration of oil tamponade was not linked to increase in unexplained visual loss (p=0.569).
CONCLUSIONS: Correlation between SO in detachment repairs and unexplained visual loss has been established, however incidence with HSO has not been compared to other agents. This study demonstrates that although SO was linked with risk-adjusted increased unexplained visual loss relative to gas tamponade, no such association was found for Densiron, on multivariable analysis.