Department of Ophthalmology, Shiga University of Medical Science, Shiga, Japan.
PLoS One. 2021 Aug 5;16(8):e0255827. doi: 10.1371/journal.pone.0255827. eCollection 2021.
To investigate the effects of internal limiting membrane (ILM) peeling on visual acuity (VA) after rhegmatogenous retinal detachment (RRD) surgery.
This retrospective analysis examined the medical records of patients with RRD who underwent vitrectomy at 26 institutions. To detect prognostic factors of VA at 6 months postoperatively (post-VA), multivariate linear regression was performed with post-VA as the objective variable; ILM peeling, sex, age, preoperative VA (pre-VA), intraocular pressure, axial length, duration of RRD, and cataract surgery served as explanatory variables. Recurrence of RRD and epiretinal membrane formation within 6 months postoperatively were compared between groups of patients with and without ILM peeling, among patients with macula-on and macula-off RRD.
The inclusion criteria were met by 523 eyes with a macula-on RRD and 364 eyes with a macula-off RRD. ILM peeling was performed in 85 eyes with a macula-on RRD and 57 eyes with a macula-off RRD. In eyes with a macula-on RRD, ILM peeling did not affect post-VA (p = 0.72). Vitrectomy without cataract surgery and poor pre-VA were significantly associated with poor post-VA (p = 0.01 and p < 0.001, respectively). In eyes with a macula-off RRD, ILM peeling, long duration of RRD, and poor pre-VA were significantly associated with poor post-VA (p = 0.037, p = 0.007, and p < 0.001, respectively). Recurrence of RRD and epiretinal membrane formation were similar between groups of patients with and without ILM peeling, among patients with macula-on and macula-off RRD. Retina sensitivity was not evaluated by microperimetry.
ILM peeling did not affect post-VA in eyes with a macula-on RRD, whereas post-VA was worse in eyes with ILM peeling than in eyes without peeling, among eyes with a macula-off RRD.
探讨内界膜（ILM）剥除对孔源性视网膜脱离（RRD）手术后视力（VA）的影响。
本回顾性分析对在 26 家机构接受玻璃体切除术的 RRD 患者的病历进行了检查。为了检测术后 6 个月时 VA（术后 VA）的预后因素，采用多元线性回归分析，将术后 VA 作为因变量；ILM 剥除、性别、年龄、术前 VA（术前 VA）、眼内压、眼轴长度、RRD 持续时间和白内障手术作为解释变量。比较了有和无 ILM 剥除的患者以及黄斑区视网膜脱离和非黄斑区视网膜脱离患者术后 6 个月内 RRD 复发和视网膜前膜形成的情况。
符合纳入标准的有黄斑区视网膜脱离 523 只眼和非黄斑区视网膜脱离 364 只眼。黄斑区视网膜脱离中有 85 只眼和非黄斑区视网膜脱离中有 57 只眼行 ILM 剥除。在黄斑区视网膜脱离中，ILM 剥除对术后 VA 无影响（p = 0.72）。未行白内障手术的玻璃体切除术和较差的术前 VA 与术后 VA 较差显著相关（p = 0.01 和 p < 0.001）。在非黄斑区视网膜脱离中，ILM 剥除、RRD 持续时间长和术前 VA 差与术后 VA 差显著相关（p = 0.037、p = 0.007 和 p < 0.001）。黄斑区视网膜脱离和非黄斑区视网膜脱离患者中，有和无 ILM 剥除的患者以及有和无 ILM 剥除的患者之间，RRD 复发和视网膜前膜形成情况相似。视网膜敏感度未通过微视野计进行评估。
在黄斑区视网膜脱离中，ILM 剥除对术后 VA 无影响，而在非黄斑区视网膜脱离中，与无 ILM 剥除的患者相比，有 ILM 剥除的患者术后 VA 更差。
