Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
VitreoRetinal Surgery, Minneapolis, Minnesota, USA.
Curr Eye Res. 2021 Dec;46(12):1867-1875. doi: 10.1080/02713683.2021.1929330. Epub 2021 May 21.
: Cystoid macular edema (CME) following cataract surgery is a well-known entity. Less is known regarding the risk factors of developing CME following repair of rhegmatogenous retinal detachments (RRD).: This was a multi-institutional study of primary RRD surgeries from 1/1/2015 through 12/31/2015. The primary outcome was the development of postoperative CME following RRD surgery. Post-operative optical coherence tomography imaging and 3 months of follow-up following RRD repair were required.: There were 1,466 eyes that met the inclusion criteria, and 140 (9.6%) developed postoperative CME following primary RRD repair. On multivariate analysis, the statistically significant metrics were older patient age (OR 1.03 per year, 95% CI 1.01 to 1.05), pre-operative proliferative vitreoretinopathy (PVR, OR 1.74, 95% 1.03 to 2.95), and cataract surgery following RRD repair (OR 2.18, 95% CI 1.47 to 3.25). Single surgery success was protective against CME (OR 0.20 (95% CI 0.14-0.30). Seventy-six (9.0%) of the phakic eyes and 60 (9.9%) of the pseudophakic eyes developed post-operative CME. Multivariate analysis showed that cataract surgery following RRD repair ( < .0001) for phakic eyes and older age ( = .0075) for pseudophakic eyes were risk factors. In eyes that underwent successful retinal reattachment with one surgery, post-operative cataract surgery ( = .0005) and pre-operative PVR ( = .0011) were risk factors for CME in this subgroup.: CME occurred in nearly 10% of the eyes following RRD repair. The biggest risk factors were recurrent RRD, preexisting PVR, older age, and cataract surgery following RRD repair.
白内障手术后的囊样黄斑水肿(CME)是一种众所周知的病症。然而,对于孔源性视网膜脱离(RRD)修复术后发生 CME 的风险因素知之甚少。
这是一项针对 2015 年 1 月 1 日至 2015 年 12 月 31 日期间进行的原发性 RRD 手术的多机构研究。主要结局是 RRD 手术后发生术后 CME。RRD 修复术后需要进行术后光学相干断层扫描成像和 3 个月的随访。
共有 1466 只符合纳入标准的眼睛,其中 140 只(9.6%)在原发性 RRD 修复后发生了术后 CME。多变量分析显示,年龄较大(每增加 1 岁,OR 1.03,95%CI 1.01-1.05)、术前增殖性玻璃体视网膜病变(PVR,OR 1.74,95%CI 1.03-2.95)和 RRD 修复后的白内障手术(OR 2.18,95%CI 1.47-3.25)是统计学上显著的指标。单次手术成功对 CME 有保护作用(OR 0.20,95%CI 0.14-0.30)。76 只(9.0%)的晶体眼和 60 只(9.9%)的假晶体眼发生了术后 CME。多变量分析显示,RRD 修复后的白内障手术(<0.0001)是晶体眼发生 CME 的危险因素,而假晶体眼年龄较大(=0.0075)是危险因素。在接受单次视网膜复位成功的眼睛中,术后白内障手术(=0.0005)和术前 PVR(=0.0011)是该亚组 CME 的危险因素。
RRD 修复后,约有 10%的眼睛发生 CME。最大的危险因素是复发性 RRD、术前 PVR、年龄较大和 RRD 修复后的白内障手术。