| Part Ⅰ Effects of viterous substitutes,Silicone oil,C3F8 and Air,on the prognosis of rhegmatogenous retinal detachmentObjective: We collected the patients with Rhegmatogenous retinal detachment(RRD)undergoing PPV.They were grouped according to different tamponade in the vitreous cavity.They are silicone oil,gas(C3F8)and air.Some indexes related to visual prognosis,rate of surgical succeed,macular thickness,subfoveal choroidal thickness and so on,before and after operation were collected and compared.And provide reference for selection of tamponade material in clinical work.Methods: 77 patients who confirmed diagnosis with rhegmatogenous retinal detachment by fundus examination after mydriasisin in our department from November 01,2020 to May 31,2021 were collected.Two patients who have PPV with C3F8,were excluded because of the failed operation.There are 75 patients we have 6--9 months follow-up.They all underwent vitrectomy in our hospital.Patients were divided into three groups according to different vitreous substitutes : G1(silicone oil)31 cases and 31 eyes,G2(long-acting gas)29case and 29 eyes,and G3(air)15 cases and 15 eyes.Outcome measures: best corrective visual acuity(BCVA),intraocular pressure(IOP),axial lengths,central macular thickness(CMT),subfoveal choroidal thickness(SCT),ellipsoid zone(EZ),area of shallow foveal avascular zone(FAZ).SPSS 18.0 statistical software were used for data analysis.Data from repeated measurements within the group were tested using the mixed linear effect mode,and the correlation was tested by Spearman correlation analysis.P <0.05 was considered statistically significant.Graphing statistics were drawn by Graph Pad Prism 5 software.Results:(1)Among the 75 patients with RRD included in the follow-up,there were 31 cases in G1 group,29 cases in G2 group and 15 cases in G3 group.There was no significant difference in preoperative general data.Compared in G1,G2 and G3 groups,the postoperative BCVA of patients was significantly improved,and there was no significant difference in the postoperative level and change trend of CMT,SCT,FAZ,axial lengths and IOP.(3)The rates of surgical succeed about the 3 groups were 100% vs 93.5% vs 100%,respectively,with no statistically significant difference(P = 0.672).Conclusion:There was no significant difference in the rate of surgical succeed and prognostic indicators between the 3 groups,silicone oil amponade,inert gas(C3F8)and air in PPV.So the range of PPV combined with air filling could be suitably xpanded.Part Ⅱ Effect of silicone oil tamponade on choroid thickness and ocular axis during PPVObjective: Analyze the changes of relevant prognostic indicators after silicone oil tamponade,to explore whether silicone oil filling has impact on the choroidal thickness and axial length.Methods: 31 patients,with silicone oil tamponade during PPV,who confirmed diagnosis with rhegmatogenous retinal detachment by fundus examination after mydriasisin in our department from November 01,2020 to May 31,2021 were collected.Outcome measures:best corrective visual acuity(BCVA),intraocular pressure(IOP),axial lengths,central macular thickness(CMT),subfoveal choroidal thickness(SCT),ellipsoid zone(EZ),area of shallow foveal avascular zone(FAZ).SPSS 18.0 statistical software were used for data analysis.Variance analysis or nonparametric tests were used for comparison between groups.P < 0.05 was considered statistically significant.Graphing statistics were drawn by Graph Pad Prism 5 software.Results:(1)SCT changements in G1 group: after silicone oil tamponade 1m and 3m,SCT are significantly thinner,and the difference was significant(231.58±107.19,211.00± 100.41 μm P = 0.005,231.58±107.19,208.10 ± 110.86 μm P = 0.001).After removal of silicone oil 6 months the SCT are lower than before,and the difference was significant(231.58±107.19,204.86 ± 107.62μm P = 0.000)。(2)Changes of axial lengths in G1 group: after of silicone oil tamponade at 1m and 3m,the axial lengths are longer,and the difference was significant(24.50、25.06 mm P = 0.040、24.50,25.12 mm P = 0.000);After removal of silicone oil 6 months the axial lengths are similar to before(24.50,24.67 P = 0.124)。Compared with silicone oil amponade 3 months,After removal of silicone oil 1m,3m and 6m are shorter,and the difference was significant(25.12,24.78 mm P = 0.003、 25.12,24.9 mm P = 0.042、 25.12,24.67 P = 0.011)。(3)The correlation analysis of G1 group: 1)There was no correlation between SCT thickness and intraocular pressure at each time point(r =-0.194、P = 0.296,r =-0.251、P = 0.173,r =-0.185、P = 0.318,r =-0.181、P = 0.330,r =-0.050、P = 0.789,r=-0.165、P = 0.378);2)There was a negative correlation between axial length and SCT during silicone oil amponade,1m and 3m(r =-0.630、 P = 0.000,r =-0.598、P = 0.000).After silicone oil removal,the axial length was negatively correlated with SCT,1m,3m,6m(r =-0.632、P = 0.000,r =-0.584、P = 0.001,r =-0.676,P = 0.000).3)Correlation between ocular axis and IOP: there was a positive correlation between ocular axis and IOP when 3m silicone oil amponade,1m and 3m silicone oil amponade(r = 0.519、P = 0.003,r = 0.495、P = 0.005).after silicone oil removal 3 months and 6 months : there was no correlation between ocular axis and IOP(r = 0.092、P = 0.622,r = 0.256 、P = 0.165).Conclusion:(1)Silicone oil amponade make SCT thinner and the ocular axis longer,but after silicone oil removal,the ocular axis can be reduced to close to the preoperative level.(2)The axial length was negatively correlated with the thinning of SCT and positively correlated with the change of IOP during silicone oil amponade. |
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