Department of Ophthalmology, Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan.
Department of Vision Informatics, Osaka University Graduate School of Medicine, Osaka, Japan.
Retina. 2021 Jun 1;41(6):1164-1173. doi: 10.1097/IAE.0000000000002994.
To compare clinical outcomes between pars plana vitrectomy (PPV), scleral buckling (SB), and PPV+SB for rhegmatogenous retinal detachment in the Japan-RD Registry.
This is a nation-wide, multicenter, observational study based on the registry data between 2016 and 2017. The failure levels were defined as Level 1 (a failure of retinal detachment repair), Level 2 (remaining silicone oil), and Level 3 (multiple surgeries to achieve reattachment). We compared cases treated by SB or PPV in the subgroup of simple rhegmatogenous retinal detachment using multivariate Cox proportional hazard models.
A total of 2,775 cases were included. Overall, 6 months any levels of failure in total, SB, PPV, and PPV+SB were 9.2% (n = 256), 6.9% (n = 48), 8.2% (n = 157), and 21.3% (n = 51), respectively. Poor visual acuity at baseline in SB and inferior rhegmatogenous retinal detachment and larger retinal tear in PPV were associated with a higher risk of failure. Pars plana vitrectomy was associated with a higher chance of achieving primary success in cases with simple RRD, especially for cases with superior RRD (adjusted hazard ratio 3.61, 95% confidence interval 2.22-5.94, P < 0.001).
In this nationwide study, surgical anatomic outcomes were equally successful in either SB or PPV. There were different baseline characteristics associated with primary success between SB and PPV.
比较日本视网膜脱离登记研究中孔源性视网膜脱离患者行玻璃体切除术(PPV)、巩膜扣带术(SB)和 PPV+SB 的临床结局。
这是一项基于 2016 年至 2017 年登记数据的全国性、多中心、观察性研究。失败级别定义为 1 级(视网膜脱离修复失败)、2 级(硅油残留)和 3 级(多次手术以实现再附着)。我们使用多变量 Cox 比例风险模型比较了单纯孔源性视网膜脱离亚组中接受 SB 或 PPV 治疗的病例。
共纳入 2775 例病例。总的来说,6 个月时总失败率、SB、PPV 和 PPV+SB 分别为 9.2%(n=256)、6.9%(n=48)、8.2%(n=157)和 21.3%(n=51)。SB 中基线视力较差和下方孔源性视网膜脱离以及 PPV 中较大的视网膜裂孔与较高的失败风险相关。PPV 与单纯性 RRD 病例获得初次成功的机会更高,尤其是上方 RRD(调整后的危险比 3.61,95%置信区间 2.22-5.94,P<0.001)。
在这项全国性研究中,SB 或 PPV 的手术解剖学结局同样成功。SB 和 PPV 之间的初次成功与不同的基线特征相关。