|
목적 : Rhegmatogenous retinal detachment (RRD) is the most commonly occurring form of retinal detachment. One of the treatment options for RRD includes pars plana vitrectomy with tamponade. In case of silicone oil (SO) use, the removal of it is required. SO removal is still unclear in terms of long-term visual prognosis. Meanwhile not so much of characteristics of re-detachment of retina is unfolded yet. The purpose of this study is to evaluate the long-term visual prognosis and determine the frequency and characteristics of retinal re-detachment after SO removal in retinal detachment patients.
방법 : Patients were recruited between January 2009 and December 2018. Retrospectively reviewed the medical charts of 1017 eyes of patients with a diagnosis of retinal detachment (RD) who had a pars plana vitrectomy with silicone oil tamponade. Retinal detachment cases such as rhegmatogenous RD, tractional RD and proliferative vitreoretinopathy (PVR) were included. Exclusion criteria were pre-existing diseases affecting the macula or the optic nerve. Intraocular surgery was performed. Best-corrected visual acuity (BCVA) was obtained preoperatively and minimum 6 months after the last vitrectomy.
결과 : Mean follow-up period were 58.08 ± 70.67 months. The retina remained attached after removal of silicone oil in 835 of the 1017 (82.1%) patients. The visual acuity measured at the latest visit was significantly better in primary attachment group (1.38 ± 1.00 vs. 2.43 ± 0.84, p<0.001). The number of retinal surgeries, the incidence of scleral encircling, the presence of PVR, diabetes mellitus and postoperative complications were not significantly different between the primary attachment group and re-detachment group. The longer the follow-up, the worse the visual acuity.
결론 : The eventual visual outcome in the present study was relatively encouraging. However, after SO removal, only 35% of the patients achieved a logMAR visual acuity of better than 1.00, and that in less than 25% of the patients, final logMAR visual acuity was higher than 0.70. This study may suggest that when discussing pars plana vitrectomy with the patient, one should take into account the timing of the retinal surgery, preoperative visual acuity, general condition of the patient and the benefit a potentially successful surgery may have on the quality of life of the patient.
|