Department of Ophthalmology, Weill Cornell Medical College, New York City, New York.
Retina Consultants of Southern California, Redlands, California.
Retina. 2019 Aug;39(8):1488-1495. doi: 10.1097/IAE.0000000000002184.
To determine predictive factors of proliferative vitreoretinopathy (PVR) formation after uncomplicated primary retinal detachment repair.
Retrospective, single-center, case-control study of 74 consecutive patients with (37 eyes) and without (37 eyes) PVR formation after undergoing uncomplicated primary surgery for retinal detachment repair. Logistic regression was used to assess factors associated with PVR formation.
Retinal detachment involving the macula was 4.2 times (adjusted odds ratio; 95% confidence interval, 1.4-12.9; P = 0.0119) more likely to have PVR formation compared with those without. Patients who were current or former smokers were 3.6 times (adjusted odds ratio; 95% confidence interval, 1.1-11.7; P = 0.0352) more likely to have PVR formation compared with nonsmokers. Compared with 25-gauge (g) vitrectomy, larger gauge vitrectomy (20 g or 23 g) was 3.6 times (adjusted odds ratio; 95% confidence interval, 1.2-11.3; P = 0.0276) more likely to have PVR formation. Duration of retinal detachment symptoms, high myopia, lens status, lattice degeneration, location of retinal break, number of retinal breaks, and surgical technique (e.g., scleral buckle with or without vitrectomy versus vitrectomy alone) were not found to be predictive of PVR formation.
Cigarette smoking and macular involvement are significant risk factors predictive of PVR formation after uncomplicated primary retinal detachment repair.
确定单纯原发性视网膜脱离修复术后发生增生性玻璃体视网膜病变(PVR)的预测因素。
回顾性、单中心、病例对照研究,纳入 74 例连续患者(37 只眼)和未发生 PVR 形成的患者(37 只眼)。使用逻辑回归评估与 PVR 形成相关的因素。
与未累及黄斑的视网膜脱离相比,累及黄斑的视网膜脱离发生 PVR 的可能性高 4.2 倍(调整优势比;95%置信区间,1.4-12.9;P = 0.0119)。与不吸烟者相比,当前吸烟者或曾经吸烟者发生 PVR 的可能性高 3.6 倍(调整优势比;95%置信区间,1.1-11.7;P = 0.0352)。与 25G 玻璃体切除术相比,20G 或 23G 玻璃体切除术发生 PVR 的可能性高 3.6 倍(调整优势比;95%置信区间,1.2-11.3;P = 0.0276)。视网膜脱离症状持续时间、高度近视、晶状体状态、格子样变性、视网膜裂孔位置、视网膜裂孔数量以及手术技术(如巩膜扣带术联合或不联合玻璃体切除术与单纯玻璃体切除术)均与 PVR 形成无关。
吸烟和黄斑受累是单纯原发性视网膜脱离修复术后发生 PVR 的显著危险因素。