Outcomes of short- versus long-acting gas tamponades in vitrectomy for rhegmatogenous retinal detachment.

Verena Schöneberger, Jeany Q Li, Leonie Menghesha, Frank G Holz, Friederike Schaub, Tim U Krohne
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Abstract

Background: In vitrectomy for rhegmatogenous retinal detachment, long-acting gas tamponades (LGT) such as C3F8 or C2F6 may improve surgical success rate due to their prolonged effect compared to a short-acting gas tamponade (SGT) with SF6. On the other hand, SGT allow a significantly faster visual rehabilitation after surgery and may reduce the risk of gas-related complications. As comparative data in retinal detachment surgery is limited, we assessed the outcomes of vitrectomies using either LGT or SGT.

Methods: We retrospectively analyzed 533 eyes of 524 consecutive patients diagnosed with primary rhegmatogenous retinal detachment not complicated by proliferative vitreoretinopathy (PVR) and treated by vitrectomy at two clinical sites. Depending on the site the patients presented at, they received either preferentially LGT (study site 1) or SGT (study site 2). Retinal re-detachment rates during a period of 6 months following surgery were analyzed.

Results: At study site 1, 254 of 278 eyes (91.4%) were treated by LGT (C3F8 72.3%; C2F6 19.1%), whereas at study site 2, 246 of 255 eyes (96.5%) received SGT (SF6). Rates of retinal re-detachment in the LGT- and SGT-treated groups were similar with 23 of 254 eyes (9.1%) and 24 of 246 eyes (9.8%), respectively (p = 0.9). Median time to re-detachment was 5.7 weeks in the LGT-treated group and 4.4 weeks in the SGT-treated group (p = 0.4).

Conclusion: In rhegmatogenous retinal detachment repair by vitrectomy, the use of SGT results in comparable rates of successful retinal re-attachment as LGT. Given the faster visual rehabilitation with SGT, these results suggest SGT as a sensible alternative to LGT in surgery of retinal detachment without PVR.

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流变性视网膜脱离玻璃体切除术中短效与长效气体填塞的效果。
背景:在流变性视网膜脱离的玻璃体切除术中,与使用 SF6 的短效气体填塞法(SGT)相比,C3F8 或 C2F6 等长效气体填塞法(LGT)的作用时间更长,因此可提高手术成功率。另一方面,SGT 可以显著加快术后视力恢复,并可降低气体相关并发症的风险。由于视网膜脱离手术的比较数据有限,我们评估了使用 LGT 或 SGT 进行玻璃体切割的结果:我们回顾性分析了在两个临床基地连续诊断出原发性流变性视网膜脱离且未并发增殖性玻璃体视网膜病变(PVR)并接受玻璃体切除术治疗的 524 名患者的 533 只眼睛。根据患者就诊地点的不同,他们优先接受了 LGT(研究地点 1)或 SGT(研究地点 2)。对术后 6 个月内的视网膜再脱落率进行了分析:在研究地点 1,278 只眼睛中有 254 只(91.4%)接受了 LGT 治疗(C3F8 72.3%;C2F6 19.1%),而在研究地点 2,255 只眼睛中有 246 只(96.5%)接受了 SGT(SF6)治疗。LGT治疗组和SGT治疗组的视网膜再脱落率相似,分别为254只眼睛中23只(9.1%)和246只眼睛中24只(9.8%)(P = 0.9)。LGT治疗组再次脱落的中位时间为5.7周,SGT治疗组为4.4周(P = 0.4):结论:在通过玻璃体切除术进行流变性视网膜脱离修复时,使用 SGT 的视网膜再粘连成功率与 LGT 相当。鉴于 SGT 能更快地恢复视力,这些结果表明,在无 PVR 的视网膜脱离手术中,SGT 是 LGT 的明智替代品。
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来源期刊
CiteScore
3.50
自引率
4.30%
发文量
81
审稿时长
19 weeks
期刊介绍: International Journal of Retina and Vitreous focuses on the ophthalmic subspecialty of vitreoretinal disorders. The journal presents original articles on new approaches to diagnosis, outcomes of clinical trials, innovations in pharmacological therapy and surgical techniques, as well as basic science advances that impact clinical practice. Topical areas include, but are not limited to: -Imaging of the retina, choroid and vitreous -Innovations in optical coherence tomography (OCT) -Small-gauge vitrectomy, retinal detachment, chromovitrectomy -Electroretinography (ERG), microperimetry, other functional tests -Intraocular tumors -Retinal pharmacotherapy & drug delivery -Diabetic retinopathy & other vascular diseases -Age-related macular degeneration (AMD) & other macular entities
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