研究目的
To assess the pathological macular changes with optical coherence tomography (OCT) before the removal of silicone oil (SiO) in eyes that had undergone pars plana vitrectomy for complicated forms of retinal detachment (RD).
研究成果
We suggest that performing noncontact OCT before the removal of SiO is important. It helps to predict visual outcome, which we found was related to cataract density and macular pathologies detected by OCT. It helps to change the surgical plan of the removal of SiO to manage treatable macular pathologies. It also helps to detect macular edema and thinning that could not be detected intraoperatively. This procedure should be performed routinely before the removal of SiO whenever the media allow. We recommend the removal of SiO earlier whenever possible before the development of dense cataracts that prevent OCT performance as a baseline care.
研究不足
1) There was a wide spectrum of diagnoses before the use of an SiO tamponade, including PVR, PDR, recurrent RD, trauma, uveitis, and GRT. We concentrated on abnormalities under SiO rather than on the primary diagnosis. 2) A small number of eyes were studied in the uveitis and GRT groups.
1：Experimental Design and Method Selection:
A cross-sectional study performed between July 2011 and September
2：The study adhered to the Tenets of the Declaration of Helsinki. The Research Ethics Committee, Faculty of Medicine, Ainshams University (FMAUS REC) approved the protocol of this study from the ethical point of view. Written informed patient consent was also obtained. Sample Selection and Data Sources:
20 Subjects included 48 patients (51 eyes) with complicated RD including proliferative vitreoretinopathy, proliferative diabetic retinopathy, recurrent RD, penetrating trauma, uveitis, giant retinal tears, and macular holes. All the eyes had undergone SiO injection. Furthermore, all eyes had been planned for the removal of SiO 6–12 months after the primary surgery.
3：List of Experimental Equipment and Materials:
Examination using OCT (Ziess Cirrus, software version 4.5; Carl Zeiss Meditec AG, Jena, Germany) was performed for the macular area by scanning across a series of six radiating cross-sectional B scans of 6 mm with the center of each scan placed at the center of the fovea using a fast macula map including central macular thickness.
4：5; Carl Zeiss Meditec AG, Jena, Germany) was performed for the macular area by scanning across a series of six radiating cross-sectional B scans of 6 mm with the center of each scan placed at the center of the fovea using a fast macula map including central macular thickness. Experimental Procedures and Operational Workflow:
4. Experimental Procedures and Operational Workflow: All patients had standard three-port sclerotomies in the pars plana,
5：5 mm from the limbus. SiO was left to flow passively under the effect of infusion fluid pressure. Endoillumination using the halogen light of a CONSTELLATION Vitrectomy Machine? (Alcon Laboratories, Inc.) was used to examine the macular region after the removal of SiO. Data Analysis Methods:
Statistical analysis was performed to evaluate OCT findings in correlation with preoperative fundus appearance, surgical findings, and visual outcome.
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