Comparison of intraoperative balanced salt solution injection or postoperative air filling for superior bullous retinal detachment
AIM: To observe the outcome of intravitreal balanced salt solution(BSS)injection to increase intraocular pressure(IOP)after extrascleral subretinal fluid drainage, then scleral buckling(SB)to treat superior bullous retinal detachment(SBRD), and compare it with the effect of conventional surgery(with...
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| Format: | Article |
| Language: | English |
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Press of International Journal of Ophthalmology (IJO PRESS)
2024-05-01
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| Series: | Guoji Yanke Zazhi |
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| Online Access: | http://ies.ijo.cn/cn_publish/2024/5/202405030.pdf |
| _version_ | 1797194682398146560 |
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| author | Wei Xinli Wu Tong Gong Min Tian Chaowei Hui Yannian Du Hongjun |
| author_facet | Wei Xinli Wu Tong Gong Min Tian Chaowei Hui Yannian Du Hongjun |
| author_sort | Wei Xinli |
| collection | DOAJ |
| description | AIM: To observe the outcome of intravitreal balanced salt solution(BSS)injection to increase intraocular pressure(IOP)after extrascleral subretinal fluid drainage, then scleral buckling(SB)to treat superior bullous retinal detachment(SBRD), and compare it with the effect of conventional surgery(without any intravitreal filling)and postoperative air filling.METHODS: Retrospective case-control study. A total of 72 patients(73 eyes)who underwent SB for SBRD from January 2018 to December 2022 in ophthalmology department of Xijing Hospital were included. The extrascleral subretinal fluid drainage was performed in all eyes. According to whether intravitreal injection was performed and different injections, patients were divided into three groups: with 24 cases(24 eyes)in the conventional group(no intravitreal injection), 23 cases(23 eyes)in the air group(sterile air was injected after surgery), and 25 cases(26 eyes)in the BSS group(BSS was injected during extrascleral subretinal fluid drainage). All patients were followed up until subretinal fluid was absorbed completely. The average surgery time, postoperative IOP, retinal reattachment rate, subretinal fluid absorption, visual acuity(LogMAR)and major complications were compared.RESULTS: All surgeries were completed successfully. The average surgery time of the conventional group, air group and BSS group were 63.17±13.22, 61.65±15.55 and 57.30±11.70 min, respectively. There had no significant difference among these groups(F=0.825, P=0.443). On the first post-operative day, the average IOP of the conventional group, air group and BSS group were 13.69±2.69, 16.40±2.86 and 18.35±2.88 mmHg, respectively. The average IOP of the air group and the BSS group were significant higher than that of the conventional group(F=17.18, P<0.001). Primary reattachment rates were 88%, 96%, and 100%, respectively. The postoperative BCVA was 0.71±0.42, 0.59±0.44, and 0.91±0.50, respectively, which were significantly higher than those before operation(all P<0.05), but there was no significant difference among groups(F=3.046, P>0.05). The main complications included subretinal hemorrhage in 1 eye from the conventional group and 1 eye from the air group, and a new retinal tear in 1 eye from the air group, resulting in localized retinal detachment.CONCLUSIONS: For SBRD patients with hypotony during SB surgery, intravitreal injection of BSS to properly increase the IOP and then complete the surgery can improve the reattachment rate and reduce postoperative complications. This method is safe and effective for selected SBRD patients. |
| first_indexed | 2024-04-24T06:00:10Z |
| format | Article |
| id | doaj.art-af20d0dc014d402dbaece52996b0281d |
| institution | Directory Open Access Journal |
| issn | 1672-5123 |
| language | English |
| last_indexed | 2024-04-24T06:00:10Z |
| publishDate | 2024-05-01 |
| publisher | Press of International Journal of Ophthalmology (IJO PRESS) |
| record_format | Article |
| series | Guoji Yanke Zazhi |
| spelling | doaj.art-af20d0dc014d402dbaece52996b0281d2024-04-23T08:29:23ZengPress of International Journal of Ophthalmology (IJO PRESS)Guoji Yanke Zazhi1672-51232024-05-0124582182510.3980/j.issn.1672-5123.2024.5.30202405030Comparison of intraoperative balanced salt solution injection or postoperative air filling for superior bullous retinal detachmentWei Xinli0Wu Tong1Gong Min2Tian Chaowei3Hui Yannian4Du Hongjun5Department of Ophthalmology, Xijing Hospital, Air Force Medical University;Eye Institute of PLA, Xi'an 710032, Shaanxi Province, China; Department of Ophthalmology, the 988th Hospital of Joint Logistic Support Force of the People's Liberation Army, Zhengzhou 450000, Henan Province, ChinaDepartment of Ophthalmology, Xijing Hospital, Air Force Medical University;Eye Institute of PLA, Xi'an 710032, Shaanxi Province, ChinaDepartment of Ophthalmology, Xijing Hospital, Air Force Medical University;Eye Institute of PLA, Xi'an 710032, Shaanxi Province, ChinaDepartment of Ophthalmology, Xijing Hospital, Air Force Medical University;Eye Institute of PLA, Xi'an 710032, Shaanxi Province, ChinaDepartment of Ophthalmology, Xijing Hospital, Air Force Medical University;Eye Institute of PLA, Xi'an 710032, Shaanxi Province, ChinaDepartment of Ophthalmology, Xijing Hospital, Air Force Medical University;Eye Institute of PLA, Xi'an 710032, Shaanxi Province, ChinaAIM: To observe the outcome of intravitreal balanced salt solution(BSS)injection to increase intraocular pressure(IOP)after extrascleral subretinal fluid drainage, then scleral buckling(SB)to treat superior bullous retinal detachment(SBRD), and compare it with the effect of conventional surgery(without any intravitreal filling)and postoperative air filling.METHODS: Retrospective case-control study. A total of 72 patients(73 eyes)who underwent SB for SBRD from January 2018 to December 2022 in ophthalmology department of Xijing Hospital were included. The extrascleral subretinal fluid drainage was performed in all eyes. According to whether intravitreal injection was performed and different injections, patients were divided into three groups: with 24 cases(24 eyes)in the conventional group(no intravitreal injection), 23 cases(23 eyes)in the air group(sterile air was injected after surgery), and 25 cases(26 eyes)in the BSS group(BSS was injected during extrascleral subretinal fluid drainage). All patients were followed up until subretinal fluid was absorbed completely. The average surgery time, postoperative IOP, retinal reattachment rate, subretinal fluid absorption, visual acuity(LogMAR)and major complications were compared.RESULTS: All surgeries were completed successfully. The average surgery time of the conventional group, air group and BSS group were 63.17±13.22, 61.65±15.55 and 57.30±11.70 min, respectively. There had no significant difference among these groups(F=0.825, P=0.443). On the first post-operative day, the average IOP of the conventional group, air group and BSS group were 13.69±2.69, 16.40±2.86 and 18.35±2.88 mmHg, respectively. The average IOP of the air group and the BSS group were significant higher than that of the conventional group(F=17.18, P<0.001). Primary reattachment rates were 88%, 96%, and 100%, respectively. The postoperative BCVA was 0.71±0.42, 0.59±0.44, and 0.91±0.50, respectively, which were significantly higher than those before operation(all P<0.05), but there was no significant difference among groups(F=3.046, P>0.05). The main complications included subretinal hemorrhage in 1 eye from the conventional group and 1 eye from the air group, and a new retinal tear in 1 eye from the air group, resulting in localized retinal detachment.CONCLUSIONS: For SBRD patients with hypotony during SB surgery, intravitreal injection of BSS to properly increase the IOP and then complete the surgery can improve the reattachment rate and reduce postoperative complications. This method is safe and effective for selected SBRD patients.http://ies.ijo.cn/cn_publish/2024/5/202405030.pdfrhegmatogenous retinal detachmentscleral bucklinghypotonybalanced salt solution(bss)air filling |
| spellingShingle | Wei Xinli Wu Tong Gong Min Tian Chaowei Hui Yannian Du Hongjun Comparison of intraoperative balanced salt solution injection or postoperative air filling for superior bullous retinal detachment Guoji Yanke Zazhi rhegmatogenous retinal detachment scleral buckling hypotony balanced salt solution(bss) air filling |
| title | Comparison of intraoperative balanced salt solution injection or postoperative air filling for superior bullous retinal detachment |
| title_full | Comparison of intraoperative balanced salt solution injection or postoperative air filling for superior bullous retinal detachment |
| title_fullStr | Comparison of intraoperative balanced salt solution injection or postoperative air filling for superior bullous retinal detachment |
| title_full_unstemmed | Comparison of intraoperative balanced salt solution injection or postoperative air filling for superior bullous retinal detachment |
| title_short | Comparison of intraoperative balanced salt solution injection or postoperative air filling for superior bullous retinal detachment |
| title_sort | comparison of intraoperative balanced salt solution injection or postoperative air filling for superior bullous retinal detachment |
| topic | rhegmatogenous retinal detachment scleral buckling hypotony balanced salt solution(bss) air filling |
| url | http://ies.ijo.cn/cn_publish/2024/5/202405030.pdf |
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