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玻璃体切除术后视网膜前膜用于孔源性视网膜脱离修复

Epiretinal membrane following pars plana vitrectomy for rhegmatogenous retinal detachment repair.

作者信息

Sella Ruti, Sternfeld Amir, Budnik Ivan, Axer-Siegel Ruth, Ehrlich Rita

机构信息

Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, Petach Tikva 4941492, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.

出版信息

Int J Ophthalmol. 2019 Dec 18;12(12):1872-1877. doi: 10.18240/ijo.2019.12.09. eCollection 2019.

Abstract

AIM

To determine the rate and possible contributors for post-pars plana vitrectomy (PPV) epiretinal membrane (ERM) in patients treated for rhegmatogenous retinal detachment (RRD).

METHODS

This prospective, nonrandomized study comprised 47 consecutive patients (47 eyes) with acute RRD treated with 23 G post-PPV. All participants were followed prospectively for 6mo for the development of ERM using spectral domain optical coherence tomography. Preoperative and intraoperative data were collected by questionnaires to surgeons. Main outcome measure was the percentage of the ERM formation following post-PPV for RRD.

RESULTS

ERM developed postoperatively in 23 eyes (48.9%), none necessitated surgical removal. There was a statistically significant difference between patients with and without ERM postoperatively in preoperative best corrected visual acuity (median logMAR 1.9 0.3, respectively; =0.003) rate of macula-off (69.6% 37.5%, respectively, =0.028), and rate of ≥5 cryo-applications (55.6% and 18.8%, respectively, =0.039). ERM developed mainly between the 1 and 3 months of follow-up. Macula-off status increased the risk of ERM, with the odds ratio of 3.81 (=0.031).

CONCLUSION

ERM is a frequent post RRD finding, and its development is associated with macula-off RRD.

摘要

目的

确定孔源性视网膜脱离(RRD)患者行玻璃体后脱离(PPV)术后视网膜前膜(ERM)的发生率及可能的相关因素。

方法

本前瞻性、非随机研究纳入47例连续的急性RRD患者(47只眼),均接受23G PPV治疗。所有参与者均采用频域光学相干断层扫描前瞻性随访6个月,观察ERM的发生情况。术前和术中数据通过向外科医生发放问卷收集。主要观察指标为RRD患者PPV术后ERM形成的百分比。

结果

术后23只眼(48.9%)发生ERM,无一例需要手术切除。术后有ERM和无ERM的患者在术前最佳矫正视力(中位数logMAR分别为1.9和0.3;P=0.003)、黄斑脱离发生率(分别为69.6%和37.5%,P=0.028)以及≥5次冷凝治疗发生率(分别为55.6%和18.8%,P=0.039)方面存在统计学显著差异。ERM主要在随访的1至3个月之间发生。黄斑脱离状态增加了ERM的发生风险,比值比为3.81(P=0.031)。

结论

ERM是RRD术后常见的发现,其发生与黄斑脱离性RRD相关。

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