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激光玻璃体溶解术后报告的并发症。

Reported Complications Following Laser Vitreolysis.

作者信息

Hahn Paul, Schneider Eric W, Tabandeh Homayoun, Wong Robert W, Emerson Geoffrey G

机构信息

NJRetina, Teaneck, New Jersey.

Tennessee Retina, Nashville.

出版信息

JAMA Ophthalmol. 2017 Sep 1;135(9):973-976. doi: 10.1001/jamaophthalmol.2017.2477.

Abstract

IMPORTANCE

Use of laser vitreolysis for symptomatic floaters has increased in recent years, but prospective studies are not available and the complication profile is poorly understood.

OBJECTIVE

To analyze cases of complications following laser vitreolysis as voluntarily reported to the American Society of Retina Specialists Research and Safety in Therapeutics (ASRS ReST) Committee, an independent task force formed to monitor device-related and drug-related safety events.

DESIGN, SETTING, AND PARTICIPANTS: A retrospective assessment was performed of all cases of complications following laser vitreolysis that were voluntarily reported by practitioners throughout the United States to the ASRS ReST Committee from the first report on September 19, 2016, through March 16, 2017, the date of data analysis and manuscript writing.

MAIN OUTCOMES AND MEASURES

Complications reported to the ASRS ReST Committee following laser vitreolysis were analyzed by type to gain an understanding of the spectrum of potential complications.

RESULTS

A total of 16 complications following laser vitreolysis were reported in 15 patients by 7 US vitreoretinal specialists during the study period. Complications included elevated intraocular pressure leading to glaucoma; cataracts, including posterior capsule defects requiring cataract surgery; retinal tear; retinal detachment; retinal hemorrhages; scotomas; and an increased number of floaters.

CONCLUSIONS AND RELEVANCE

This report presents a spectrum of complications reported to the ASRS ReST Committee across 6 months. The rate of complications cannot be determined because the denominator of total cases is unknown. Also, these findings cannot determine whether there is a causal association between these complications and laser vitreolysis. Prospective studies are warranted to better understand the efficacy of this procedure and the frequency of attendant complications. Until then, practitioners should be aware of the profile of potential complications to properly inform patients during the consent process. The ASRS ReST Committee will continue to monitor device-related and drug-related adverse events and encourages active surveillance and reporting by all physicians.

摘要

重要性

近年来,激光玻璃体溶解术用于治疗有症状的飞蚊症的情况有所增加,但尚无前瞻性研究,且对其并发症情况了解甚少。

目的

分析自愿向美国视网膜专家协会治疗研究与安全委员会(ASRS ReST)报告的激光玻璃体溶解术后并发症病例,该委员会是一个独立的特别工作组,旨在监测与设备和药物相关的安全事件。

设计、地点和参与者:对2016年9月19日首次报告至2017年3月16日(数据分析和撰写稿件之日)期间,美国各地从业者自愿向ASRS ReST委员会报告的所有激光玻璃体溶解术后并发症病例进行回顾性评估。

主要结局和测量指标

按类型分析向ASRS ReST委员会报告的激光玻璃体溶解术后并发症,以了解潜在并发症的范围。

结果

在研究期间,7位美国玻璃体视网膜专家报告了15例患者的16例激光玻璃体溶解术后并发症。并发症包括导致青光眼的眼压升高;白内障,包括需要白内障手术的后囊膜缺损;视网膜裂孔;视网膜脱离;视网膜出血;暗点;以及飞蚊症数量增加。

结论和相关性

本报告呈现了6个月内向ASRS ReST委员会报告的一系列并发症。由于总病例数的分母未知,无法确定并发症发生率。此外,这些发现无法确定这些并发症与激光玻璃体溶解术之间是否存在因果关系。有必要进行前瞻性研究,以更好地了解该手术的疗效和伴随并发症的发生率。在此之前,从业者应了解潜在并发症情况,以便在知情同意过程中向患者充分说明。ASRS ReST委员会将继续监测与设备和药物相关的不良事件,并鼓励所有医生积极监测和报告。

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