Enders Philip, Schick Tina, Schaub Friederike, Kemper Carolin, Fauser Sascha
Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany.
Retina. 2017 May;37(5):930-935. doi: 10.1097/IAE.0000000000001302.
To evaluate functional and anatomical outcomes of patients with retinal redetachments (re-RD) after surgery for primary rhegmatogenous retinal detachment.
Medical records of eyes with re-RD after rhegmatogenous retinal detachment surgery between 1999 and 2014 at the Department of Ophthalmology, University of Cologne, Germany, were retrospectively evaluated. Data included preoperative and postoperative clinical findings, best-corrected visual acuity, presence and grade of proliferative vitreoretinopathy, surgical procedures, and complication rates.
Three hundred and twenty-eight eyes of 2,457 developed a re-RD (13.3%). Of these 328 eyes, 242 eyes (73.8%) had only one re-RD, whereas 86 eyes (26.2%) had 2 or more re-RDs. Visible presence of proliferative vitreoretinopathy during first redetachment surgery increased risk of re-RD with relative risk ratio of 1.46 (P = 0.05). Best-corrected visual acuity deteriorated with every additional re-RD (P < 0.001). Two hundred and thirty-seven eyes received oil endotamponde at least once. In 91 cases, oil endotamponade was left for long-term until last follow-up.
Multiple re-RD (≥2 re-RDs) is an infrequent complication after rhegmatogenous retinal detachment surgery. After a first re-RD occurred, risk for multiple re-RD doubles compared with the risk of a first redetachment. Mean functional outcome is unfavorable, whereas predictability remains nevertheless poor because of the wide range of interindividual postoperative best-corrected visual acuity.
评估原发性孔源性视网膜脱离手术后视网膜再次脱离(re-RD)患者的功能和解剖学预后。
回顾性评估1999年至2014年德国科隆大学眼科原发性孔源性视网膜脱离手术后发生re-RD患者的病历。数据包括术前和术后的临床检查结果、最佳矫正视力、增殖性玻璃体视网膜病变的存在情况和分级、手术方式以及并发症发生率。
2457例患者中有328只眼发生了re-RD(13.3%)。在这328只眼中,242只眼(73.8%)仅发生一次re-RD,而86只眼(26.2%)发生了2次或更多次re-RD。首次视网膜脱离手术时可见增殖性玻璃体视网膜病变增加了再次视网膜脱离的风险,相对风险比为1.46(P = 0.05)。每次额外发生一次re-RD,最佳矫正视力都会恶化(P < 0.001)。237只眼至少接受过一次硅油眼内填充。91例中,硅油眼内填充一直保留至最后一次随访。
多次re-RD(≥2次re-RD)是孔源性视网膜脱离手术后罕见的并发症。首次发生re-RD后,多次re-RD 的风险是首次视网膜脱离风险的两倍。平均功能预后不佳,然而由于个体术后最佳矫正视力差异较大,预测性仍然很差。