Park Sung Who, Kwon Han Jo, Byon Ik Soo, Lee Ji Eun, Oum Boo Sup
Department of Ophthalmology, Pusan National University Hospital, Busan, Korea.
Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Korean J Ophthalmol. 2017 Aug;31(4):328-335. doi: 10.3341/kjo.2016.0024. Epub 2017 Jun 26.
The purpose of this study is to investigate new prognostic factors in associated with primary anatomical failure after scleral buckling (SB) for uncomplicated rhegmatogenous retinal detachment (RRD).
The medical records of patients with uncomplicated RRD treated with SB were retrospectively reviewed. Eyes with known prognostic factors for RRD, such as fovea-on, proliferative vitreoretinopathy, pseudophakia, aphakia, multiple breaks, or media opacity, were excluded. Analysis was performed to find correlations between anatomical success and various parameters, including age.
This study analyzed 127 eyes. Binary logistic regression analysis revealed that older age (≥35) was the sole independent prognostic factor (odds ratio, 3.5; p = 0.022). Older age was correlated with worse preoperative visual acuity (p < 0.001), shorter symptom duration (p < 0.001), presence of a large tear (p < 0.001), subretinal fluid drainage (p < 0.001), postoperative macular complications (p = 0.048), and greater visual improvement (p = 0.003).
Older age (≥35) was an independent prognostic factor for primary anatomical failure in SB for uncomplicated RRD. The distinguished features of RRD between older and younger patients suggest that vitreous liquefaction and posterior vitreous detachment are important features associated with variation in surgical outcomes.
本研究旨在探讨单纯孔源性视网膜脱离（RRD）巩膜扣带术（SB）后与原发性解剖失败相关的新的预后因素。
回顾性分析接受SB治疗的单纯RRD患者的病历。排除具有已知RRD预后因素的眼，如黄斑在位、增殖性玻璃体视网膜病变、人工晶状体眼、无晶状体眼、多个裂孔或介质混浊。进行分析以寻找解剖学成功与包括年龄在内的各种参数之间的相关性。
本研究分析了127只眼。二元逻辑回归分析显示，年龄较大（≥35岁）是唯一的独立预后因素（比值比，3.5；p = 0.022）。年龄较大与术前视力较差（p < 0.001）、症状持续时间较短（p < 0.001）、存在大裂孔（p < 0.001）、视网膜下液引流（p < 0.001）、术后黄斑并发症（p = 0.048）以及视力改善较大（p = 0.003）相关。
年龄较大（≥35岁）是单纯RRD的SB原发性解剖失败的独立预后因素。老年和年轻患者RRD的不同特征表明，玻璃体液化和玻璃体后脱离是与手术结果差异相关的重要特征。
