Zhonghua Yan Ke Za Zhi. 2026 Jan 11;62(1):18-25. doi: 10.3760/cma.j.cn112142-20250620-00280.
ABSTRACT
Objective: To investigate the clinical effect of performing a 12 o’clock peripheral iridectomy during vitrectomy with heavy silicone oil tamponade in aphakic eyes. Methods: This was a prospective controlled study. Patients diagnosed with tractional retinal detachment secondary to proliferative diabetic retinopathy and scheduled to undergo combined lens extraction and pars plana vitrectomy with heavy silicone oil tamponade at the Department of Ophthalmology, Second Affiliated Hospital of Harbin Medical University between January and December 2024 were enrolled in this study. Patients were randomly assigned, using a random number table, to either the combined group (undergoing aphakic vitrectomy with heavy silicone oil tamponade and a 12 o’clock peripheral iridectomy) or the simple group (undergoing aphakic vitrectomy with heavy silicone oil tamponade but without a peripheral iridectomy). Intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were recorded preoperatively and at 1 day, 1, 4, and 12 weeks postoperatively. These measures, along with postoperative silicone oil migration into the anterior chamber, corneal condition, retinal reattachment status, and other complications, were compared between the two groups. Statistical analyses were performed using the independent-samples t-test, independent-samples Mann-Whitney U test, and chi-square (χ²) test. Results: A total of 20 patients (20 eyes) were enrolled, including 11 males (11 eyes) and 9 females (9 eyes), with a mean age of (59.65±8.92) years (range, 46 to 78 years). There were 10 eyes in each of the combined and simple groups. No statistically significant differences were found between the two groups in terms of age, BCVA, or IOP at baseline (all P>0.05). At 1, 4, and 12 weeks postoperatively, the IOP in the combined group [(20.78±4.06), (20.82±3.67), and (21.00±3.14) mmHg; 1 mmHg=0.133 kPa] was significantly lower than that in the simple group [(25.15±4.63), (28.52±8.12), and (29.80±8.34) mmHg], with statistically significant differences at all time points (all P<0.05). There were no statistically significant differences in BCVA between the two groups at any postoperative time point (all P>0.05). Silicone oil migration into the anterior chamber occurred in only one eye in the combined group at 12 weeks postoperatively, whereas in the simple group, 0, 2, 5, and 7 eyes exhibited silicone oil in the anterior chamber at 1 day, 1, 4, and 12 weeks, respectively. Regarding corneal edema (grade≥1), the number of affected eyes in the combined group was 3, 1, 1, and 1 at the corresponding time points, while in the simple group it was 3, 2, 5, and 6, respectively. Additionally, at 12 weeks postoperatively, one eye in the simple group showed persistent retinal detachment, and one eye in the combined group exhibited closure of the peripheral iridectomy incision. Conclusion: Performing a 12 o’clock peripheral iridectomy during vitrectomy with heavy silicone oil tamponade in aphakic eyes can effectively control postoperative IOP, reduce the incidence of silicone oil migration into the anterior chamber, alleviate postoperative complications, and enhance surgical safety.
PMID:41491508 | DOI:10.3760/cma.j.cn112142-20250620-00280
