To investigate the factors related to the occurrence of submacular fluid (SMF) after pars plana vitrectomy (PPV) in the treatment of rhegmatogenous retinal detachment (RRD).
A retrospective case series observational study was performed.A total of 103 patients (103 eyes) with RRD who underwent 23G vitrectomy combined with silicone oil tamponade in The First Affiliated Hospital of Zhengzhou University from May 2017 to August 2019 were included.There were 55 males and 48 females, aged from 17 to 77, with an average of (48.65±15.80) years.The macular morphology was observed by optical coherence tomography (OCT) before surgery and 1 month and 3 months after surgery.The patients were divided into SMF group and no SMF group according to OCT results at 1 month after surgery.Clinical data were compared and analyzed, including age, gender, duration of symptoms, axial length, the preoperative status of macula (on or off), retinal detachment caused by inferior retinal break or not, the way to drain subretinal fluid intraoperative, best corrected visual acuity (BCVA). FFA was performed in 3 eyes and microperimeter examination in 2 eyes with SMF according to patients’ willingness.A multivariate binary Logistic regression was used to analyze the risk factors of SMF after vitrectomy in RRD patients.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2020-KY-334). Written informed consent was obtained from each subject prior to surgery.
Postoperative optical fundus examination and ocular ultrasound indicated that retinas of all eyes were completely anatomically reattached.There were 10.7% (11/103) of eyes developed SMF.The microperimeter examination results of 2 patients showed that their visual functions were worse at 3 months than those at 1 month after operation.The BCVA of patients with SMF at 1 month and 3 months after operation were worse than those without SMF, and the differences were statistically significant (both at P<0.05). Logistic regression analysis showed that macula-off RD before surgery and RD caused by inferior break of retina were risk factors for the occurrence of SMF (OR=6.401, P=0.041; OR=19.819, P=0.005), while the increasing age and the drainage of subretinal fluid through draining hole were protective factors (OR=0.939, P=0.016; OR=0.123, P=0.040).
Macula-off RD before surgery, and RD caused by inferior break of retina may be the risk factors of SMF after PPV combined with silicone oil tamponade for RRD.Nevertheless, the increasing age and the drainage of subretinal fluid through draining hole may decrease the occurrence of SMF.And SMF after PPV may delay visual recovery.