Takamidou Yuki, Mizuguchi Tadashi, Sakurai Ryouta, Sugimoto Mitsuo, Tanikawa Atsuhiro, Horiguchi Masayuki
Department of Ophthalmology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan.
Fujita Med J. 2022 Feb;8(1):25-30. doi: 10.20407/fmj.2020-027. Epub 2021 Mar 20.
The purpose of this study was to examine the incidence of, and risk factors for, epiretinal membrane (ERM) surgery after an initial pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).
The records of consecutive patients (3,495 eyes of 3,387 patients) who underwent RRD repair at Fujita Health University Hospital between January 1, 2008, and February 28, 2019, were retrospectively reviewed. A total of 1,736 eyes without an ERM in preoperative optical coherence tomography were included in this study.
The incidence of ERM surgery after RRD repair was 2.4%. The mean time from RRD repair to ERM surgery was 19.5±27.2 months. The odds ratios after adjusting for age and sex were as follows: the preoperative visual acuity (logarithm of the minimum angle of resolution, logMAR), 2.17 (p=0.02; 95% confidence interval [CI], 1.11-5.16); axial length, 1.38 (p=0.002; 95% CI, 1.12-1.72); 20-gauge vitreous surgery instruments, 3.82 (p<0.0001; 95% CI, 2.02-7.16); internal limiting membrane (ILM) peeling, 0.28 (p=0.033; 95% CI, 0.05-0.92). ERM surgery improved visual acuity from 0.36 to 0.01 logMAR, even at ≥1.5 years after RRD repair.
Careful follow-up is required in the following cases: long axial length before RRD repair, low visual acuity, use of 20-gauge vitreous surgery instruments, and a lack of ILM peeling.
本研究旨在探讨孔源性视网膜脱离（RRD）初次玻璃体切割术（PPV）后视网膜前膜（ERM）手术的发生率及危险因素。
回顾性分析2008年1月1日至2019年2月28日在藤田保健大学医院接受RRD修复术的连续患者（3387例患者的3495只眼）的病历。本研究纳入了术前光学相干断层扫描中无ERM的1736只眼。
RRD修复术后ERM手术的发生率为2.4%。从RRD修复到ERM手术的平均时间为19.5±27.2个月。调整年龄和性别后的优势比分别为：术前视力（最小分辨角对数，logMAR），2.17（p=0.02；95%置信区间[CI]，1.11-5.16）；眼轴长度，1.38（p=0.002；95%CI，1.12-1.72）；20G玻璃体手术器械，3.82（p<0.0001；95%CI，2.02-7.16）；内界膜（ILM）剥除，0.28（p=0.033；95%CI，0.05-0.92）。即使在RRD修复术后≥1.5年，ERM手术也能将视力从0.36 logMAR提高到0.01 logMAR。
在以下情况下需要密切随访：RRD修复术前眼轴长、视力低、使用20G玻璃体手术器械以及未进行ILM剥除。
