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与孔源性视网膜脱离行巩膜外加压术后效果相关的因素:422 例回顾性研究。

Factors associated with outcomes of pneumatic retinopexy for rhegmatogenous retinal detachments: a retrospective review of 422 cases.

机构信息

*Department of Ophthalmology, University of Montreal, Montreal, Quebec, Canada; and †Department of Ophthalmology, Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada.

出版信息

Retina. 2014 Apr;34(4):693-9. doi: 10.1097/IAE.0b013e3182a2e6ee.

DOI:10.1097/IAE.0b013e3182a2e6ee
PMID:23974997
Abstract

BACKGROUND

To determine the factors associated with anatomical and visual outcomes, and complications when using pneumatic retinopexy in the management of rhegmatogenous retinal detachments.

METHODS

On a whole, 406 patients having undergone 422 primary pneumatic retinopexies for the management of rhegmatogenous retinal detachment at a tertiary care hospital, between January 2004 and December 2009, with a minimum follow-up of 3 months were included in this case series. Multivariate logistic regression was used to estimate associations of demographic and clinical factors with anatomical and visual outcomes.

RESULTS

The single operation success rate was 60.7%, and final anatomical success was 99.5%. Male gender and the presence of complications were associated with single operation failure, whereas age over 65 years, poor preoperative visual acuity, the presence of complications were associated with poorer visual outcomes. Better preoperative visual acuity and absence of complications were associated with obtaining both a good visual outcome and anatomical success after a single intervention. The most common complications included new or missed tears (16.3%), delayed subretinal fluid reabsorption (12.1%), and epiretinal membrane (10.2%).

CONCLUSION

Several factors are associated with pneumatic retinopexy outcomes for rhegmatogenous retinal detachments. These factors should be taken into consideration when identifying patients who would benefit from pneumatic retinopexy and those who are at risk of requiring additional interventions.

摘要

背景

为了确定与解剖和视觉结果相关的因素,以及在管理孔源性视网膜脱离时使用气动视网膜固定术的并发症。

方法

本病例系列研究共纳入 2004 年 1 月至 2009 年 12 月在一家三级保健医院接受 422 例原发性气动视网膜固定术治疗孔源性视网膜脱离的 406 例患者,随访时间至少为 3 个月。采用多变量逻辑回归估计人口统计学和临床因素与解剖和视觉结果的关联。

结果

单次手术成功率为 60.7%,最终解剖成功率为 99.5%。男性和存在并发症与单次手术失败相关,而年龄超过 65 岁、术前视力差、存在并发症与较差的视觉结果相关。较好的术前视力和无并发症与单次干预后获得良好的视觉和解剖结果相关。最常见的并发症包括新的或遗漏的裂孔(16.3%)、视网膜下液延迟吸收(12.1%)和视网膜内膜(10.2%)。

结论

孔源性视网膜脱离的气动视网膜固定术结果与多个因素相关。在确定哪些患者将从气动视网膜固定术受益以及哪些患者有需要额外干预的风险时,应考虑这些因素。

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