视网膜脱离巩膜扣带术后持续性视网膜下积液与视力的关系

Relationship between persistent subretinal fluid and visual acuity after scleral buckling surgery for retinal detachment

目的探讨视网膜脱离巩膜扣带术后持续性视网膜下积液的发生率、持续时间、相关因素及对视力的影响。方法本研究纳入44例原发性孔源性视网膜脱离患者,44只眼均成功行巩膜扣带术使视网膜复位。在术前及术后1、2、3、6、12个月随访期间进行了全面的眼科检查,包括最佳矫正视力、裂隙灯生物显微镜、非接触眼压计测量眼压、光学相干断层扫描。观察术前及术后参数与视网膜下积液(SRF)的相关性。结果在术后2周时,28例(63.64%)患者有SRF,平均吸收时间为(4.81±4.12)个月。SRF组平均年龄较无SRF组平均年龄更低(28.92±12.43 vs.47.68±12.19,P=0.001),累及黄斑组较未累及黄斑组的患者SRF的发生率更高(85.71%vs.56.25%,P=0.032)。在28例SRF组的患者中,术后1个月时的平均视力较术后12个月时的平均视力更低(0.77±0.54 vs.0.45±0.28,P=0.002)。在33例累及黄斑组的患者中,术后1个月时,无积液组和未吸收组视力比较,差异有统计学意义(P<0.05);3月组(3个月以内积液完全吸收)与未吸收组视力比较,差异有统计学意义(P<0.05);而在术后12个月时各组的视力比较,差异无统计学意义(P>0.05)。结论年龄较轻和术前视网膜脱离累及黄斑的患者更容易发生PSF。PSF影响患者术后短时间内的视力恢复,对于最终最佳矫正视力(BCVA)无明显影响。

【Objective】To study the incidence,duration,related factors,and visual acuity of persistent subretinal fluid after scleral buckling surgery for retinal detachment.【Methods】In this study,forty-four patients with primary rhegmatogenous retinal detachment,44 eyes,underwent successful scleral buckling to reattach the retina.A comprehensive ophthalmic examination,including best-corrected visual acuity,slit-lamp biomicroscopy,intraocular pressure measurement by non-contact tonometry,and optical coherence tomography,was conducted preoperatively and during follow-up at 1,2,3,6,and 12 months postoperatively.The correlation between postoperative parameters and SRF were also observed.【Results】The study was conducted on a total of 44 patients[23 males(52.27%)and 21 females(47.73%)],with a mean age of 36 years.At 2 weeks after operation,28(63.64%)patients had SRF,and their mean absorption time was 4.81±4.12 months.The mean age was lower in the SRF group than in the non SRF group(28.92±12.43 vs.47.68±12.19,P=0.001),and the incidence of SRF was higher in patients with macular involvement than in patients without macular involvement(85.71%vs.56.25%,P=0.032).Among the 28 patients in the SRF group,the mean visual acuity at 1 month postoperatively was lower than that at 12 months postoperatively(0.77±0.54 vs.0.45±0.28,P=0.002).In 33 patients with macular involvement,there was a significant difference in visual acuity between the non-absorbed group without effusion and the non-absorbed group at 1 month after surgery,and there was a significant difference in visual acuity between the 3-month group(complete absorption of effusion within 3 months)and the non-absorbed group.However,there was no significant difference in visual acuity among the groups at 12 months after surgery.【Conclusion】Patients at a younger age and with macular involvement from preoperative retinal detachment were more likely to have PSF.Moreover,PSF may affect the visual recovery of patients in a short time after surgery while no significant effect on the final level of BCVA was observed.