Department of Sense Organs, Sapienza University of Rome, Policlinico Umberto I University Hospital, Head and Neck Department, Rome, Italy .
Retina. 2022 Jul 1;42(7):1268-1276. doi: 10.1097/IAE.0000000000003475. Epub 2022 Mar 11.
To investigate the incidence and risk factors for the main complications in patients with rhegmatogenous retinal detachment treated with scleral buckling (SB) or pars plana vitrectomy (PPV).
A retrospective, comparative, observational study was conducted. The medical records of 107 patients with primary rhegmatogenous retinal detachment who were managed with SB (n = 57) or PPV (n = 50) were reviewed. Scleral buckling was performed using scleral encircling solid silicone band and circumferential solid silicone exoplant to support the break. Pars plana vitrectomy was combined with phacoemulsification in phakic eyes and with scleral encircling in inferior detachments. Follow-ups, including spectral-domain optical coherence tomography examination, were scheduled at 1, 3, and 12 months after surgery. Propensity score matching was used to adjust for potential preoperative selection bias.
The overall incidence of postoperative cystoid macular edema (CME) and epiretinal membrane was 14.95% and 30.84%, respectively. Compared with SB, CME was more frequent in the PPV (P = 0.021) and in the PPV pseudophakic eyes (P = 0.027). Postoperative CME was an early, predominantly transient complication and regressed in 67% of SB and in 77% of PPV eyes within 12 months after surgery. No differences were observed regarding epiretinal membrane development. Except for the surgical technique, no preoperative factors associated with CME were identified. A correlation between epiretinal membrane and patients' age was found (P = 0.028).
The incidence of CME after rhegmatogenous retinal detachment repair was higher in patients who underwent PPV, either alone or combined with phacoemulsification, than in those treated with SB. Epiretinal membrane development was correlated to older age, regardless of the surgical procedure.
研究巩膜扣带术（SB）或玻璃体切除术（PPV）治疗孔源性视网膜脱离患者主要并发症的发生率和危险因素。
这是一项回顾性、对比性、观察性研究。对 107 例原发性孔源性视网膜脱离患者的病历进行了回顾性分析，其中 57 例患者接受 SB 治疗，50 例患者接受 PPV 治疗。SB 采用巩膜环绕硅胶带和环扎外硅胶垫支撑裂孔。在有晶状体眼行玻璃体切除术联合白内障超声乳化术，在下方视网膜脱离行巩膜环扎术。术后随访包括频域光学相干断层扫描检查，分别在术后 1、3 和 12 个月进行。采用倾向评分匹配法调整潜在的术前选择偏倚。
术后黄斑囊样水肿（CME）和视网膜内膜的总发生率分别为 14.95%和 30.84%。与 SB 相比，PPV （P = 0.021）和 PPV 无晶状体眼（P = 0.027）中 CME 更为常见。术后 CME 是一种早期、主要为一过性的并发症，67%的 SB 眼和 77%的 PPV 眼在术后 12 个月内消退。视网膜内膜的发展无差异。除手术技术外，未发现与 CME 相关的术前因素。发现视网膜内膜与患者年龄有关（P = 0.028）。
与 SB 治疗相比，单独或联合白内障超声乳化术的 PPV 治疗孔源性视网膜脱离患者术后 CME 的发生率更高。无论手术方式如何，视网膜内膜的发生都与年龄有关。
