■研究硅油取出后复发性孔源性视网膜脱离(RRD)的预后因素。
■这项回顾性研究纳入了2012年1月至2022年5月在一家以大批量转诊为基础的三级医院接受硅油填塞治疗的147例连续RRD患者。所有患者在随后的硅油去除后接受至少6个月的随访。主要结果指标是硅油取出后视网膜脱离的复发率,次要结局是硅油去除后的最佳矫正视力。
■平均硅油填充时间为4.75.01个月(范围:1-38个月;中位数:3个月),硅油取出后视网膜脱离的复发率为15.6%。Logistic回归分析显示,硅油去除过程中的氩内激光光凝(比值比[OR]:0.31;95%置信区间[CI]:0.106-0.898;p=0.031)与硅油去除后较低的解剖成功率相关。人口统计,术前眼部特征,增生性玻璃体视网膜病变,先前的巩膜环绕或屈曲,既往视网膜切除术,伴随超声乳化术,硅油填塞的持续时间,硅油取出后的气体填塞与硅油取出后的复发性视网膜再脱离没有显着相关。硅油填塞的持续时间(OR:1.23;95%CI:1.07-1.40;p=0.003)和硅油取出后复发性视网膜脱离(OR,3.40;95%CI,1.31-8.82;p=0.012)与硅油去除后视力不良相关。
■在本研究中检查的所有因素中,包括硅油填塞的持续时间,激光视网膜固定术是硅油取出后复发性视网膜脱离的唯一重要预后因素.硅油填充的持续时间较长与较差的视觉结果和去除硅油后的视觉改善率较低相关。
OBJECTIVE: To investigate the prognostic factors for recurrent rhegmatogenous retinal detachment following silicone oil removal.
METHODS: This retrospective review included 147 consecutive patients with rhegmatogenous retinal detachment treated with silicone oil tamponade at a high-volume referral-based tertiary hospital between January 2012 and May 2022. All patients underwent follow-up for a minimum of 6 months after subsequent silicone oil removal. The primary outcome measure was the rate of recurrent retinal detachment following silicone oil removal, and the secondary outcome was best-corrected visual acuity after silicone oil removal.
RESULTS: The mean silicone oil tamponade duration was 4.7 ± 5.01 months (range, 1-38 months; median, 3 months), and the recurrent retinal detachment rate after silicone oil removal was 15.6%. Logistic regression analysis revealed that argon endolaser photocoagulation during silicone oil removal (odds ratio [OR], 0.309; 95% confidence interval [CI], 0.106-0.898; p = 0.031) was associated with a lower rate of anatomical success after silicone oil removal. Demographics, preoperative ocular characteristics, proliferative vitreoretinopathy, previous scleral encircling or buckling, previous retinectomy, concomitant phacoemulsification, duration of silicone oil tamponade, and gas tamponade after silicone oil removal were not significantly associated with recurrent retinal redetachment after silicone oil removal. Duration of silicone oil tamponade (OR, 1.226; 95% CI, 1.073-1.402; p = 0.003) and recurrent retinal detachment after silicone oil removal (OR, 3.400; 95% CI, 1.311-8.817; p = 0.012) were associated with poor visual outcomes after silicone oil removal.
CONCLUSIONS: Among all factors examined in this study, including the duration of silicone oil tamponade, laser retinopexy was the only significant prognostic factor for recurrent retinal detachment after silicone oil removal. A longer duration of silicone oil tamponade was associated with worse visual outcomes and a lower rate of visual improvement after silicone oil removal.