Effectiveness of intraoperative optical coherence tomography on vitrectomy for proliferative diabetic retinopathy
Effectiveness of intraoperative optical coherence tomography on vitrectomy for proliferative diabetic retinopathy
复制标题
术中光学相干断层扫描对增殖性糖尿病视网膜病变玻璃体切除术的疗效
DOI：
10.1007/s10384-022-00944-x
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发表时间：
2022
影响因子：
2.4
通讯作者：
Yamashita Hidetoshi
中科院分区：
文献类型：
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作者：
Nishitsuka Koichi;Nishi Katsuhiro;Yamashita Hidetoshi
目的我们试图验证术中光学相干断层扫描（iOCT）对玻璃体切除术治疗增生性糖尿病视网膜病变（PDR）的效果。研究设计回顾性研究。方法我们回顾了2013年4月至2017年12月期间由一名外科医生进行25号玻璃体切除术治疗的178只患有PDR的眼睛。本研究共纳入了77例使用iOCT进行玻璃体切除术治疗的PDR患者（平均年龄，52.5 ± 11.7岁）的98只眼（iOCT组）和60例未使用iOCT治疗的PDR患者（平均年龄，53.1 ± 10.9岁）的80只眼（非iOCT组）。为了确定玻璃体切除术与iOCT联合治疗的效果，对接受该联合治疗的患者和接受玻璃体切除术但未使用iOCT治疗的患者进行了比较。根据术中并发症、再手术率、术后并发症、手术时间和术后视力评估这些治疗的效果。结果与非iOCT组（91.3 ± 31.2 min）相比，iOCT组（72.9 ± 23.9 min）的手术时间显著缩短（P = 0.001）。两组的术中并发症、再次手术和术后并发症的发生率无显著差异（分别为P = 0.542、0.258和0.860）。术后6个月，两组的术后视力无显著差异（P =.508）。多元线性回归分析显示，手术时间与iOCT显著相关（β [标准偏回归系数]=-0.28，P <.001），纤维血管增生膜（β = 0.17，P =.009），白内障手术（β = 0.22，P = 0.016），术前视网膜光凝（β = − 0.14，P = 0.021），术中并发症（β = 0.16，P = 0.023）和玻璃体后脱离（β = − 0.14，P = 0.04）。结论iOCT的使用缩短了手术时间，而不影响术中和术后并发症的发生率、再手术率，或因PDR接受玻璃体手术的患者术后视力。
PurposeWe sought to verify the effect of intraoperative optical coherence tomography (iOCT) on vitrectomy for the treatment of proliferative diabetic retinopathy (PDR).Study designRetrospective study.MethodsWe reviewed 178 eyes with PDR treated with 25-gauge vitrectomy by a single surgeon between April 2013 and December 2017. In total, 98 eyes of 77 patients with PDR (mean age, 52.5 ± 11.7 years) treated with vitrectomy using iOCT (iOCT group) and 80 eyes of 60 patients with PDR (mean age, 53.1 ± 10.9 years) treated without iOCT (non-iOCT group) were included in the study. To determine the effects of combining vitrectomy with iOCT, a comparison was made of patients treated with this combination and patients treated with vitrectomy without iOCT. The effects of these treatments were assessed on the basis of intraoperative complications, reoperation ratios, postoperative complications, operation times, and postoperative visual acuity.ResultsThe operation time was significantly reduced for the iOCT group (72.9 ± 23.9 min) when compared with the non-iOCT group (91.3 ± 31.2 min) (P= .001). The incidences of intraoperative complications, reoperation, and postoperative complications did not differ significantly between the 2 groups (P= .542, 0.258, and 0.860 respectively). Six months after surgery, the postoperative visual acuity did not differ significantly between the 2 groups (P= .508). Multiple linear regression analysis revealed that the operation time was significantly correlated with iOCT (beta [standard partial regression coefficient] = − 0.28,P< .001), the fibrovascular proliferative membrane (beta = 0.17,P= .009), cataract surgery (beta = 0.22,P= .016), preoperative retinal photocoagulation (beta = − 0.14,P= .021), intraoperative complications (beta = 0.16,P= .023), and posterior vitreous detachment (beta = − 0.14,P= .04).ConclusionUse of iOCT reduced the operation time without affecting the incidence rates of intraoperative and postoperative complications, reoperation ratios, or postoperative visual acuities in patients who underwent vitreous surgery for PDR.