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原发性玻璃体切除术中用于孔源性视网膜脱离的360度激光视网膜光凝术:与其使用相关的因素及其对手术结果的影响

360-Degree laser retinopexy in primary vitrectomy for rhegmatogenous retinal detachment: factors associated with its use and impact on surgical outcomes.

作者信息

Peters Matthew C, Murray-Douglass Alexander, Park Joseph, Cheng Sean S H, Sharma Anil K, Sharma Abhishek, Vandeleur Kevin W, Lee Lawrence R, Moloney Thomas P

机构信息

Ophthalmology Department, Royal Brisbane and Women's Hospital, Level 8, Ned Hanlon Building, Butterfield Street, Herston, QLD, 4029, Australia.

出版信息

Int J Retina Vitreous. 2022 Apr 6;8(1):28. doi: 10.1186/s40942-022-00377-1.

Abstract

BACKGROUND

To determine patient and surgical factors associated with the use of 360-degree laser retinopexy during primary pars plana vitrectomy (PPV) ± scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) and its impact on surgical outcomes.

METHODS

Patients who underwent PPV ± SB for repair of non-complex RRD at a single centre were included in this retrospective study. The primary outcome was single surgery anatomical success (SSAS). Secondary outcomes included visual acuity, epiretinal membrane formation, the presence of cystoid macular oedema, tonic pupil and corneal epithelial defects. Multiple logistic regression and multivariate regression was used.

RESULTS

The study included 192 cases, of which 130 received 360-degree laser. Worse preoperative logMAR visual acuity (P = 0.009), male sex (P = 0.060), higher PVR grades, supplemental SB (P = 0.0468) and silicone oil/CF tamponade (P < 0.0001) were associated with 360-degree laser use. No significant associations between 360-degree laser and SSAS (P = 0.079), final logMAR visual acuity (P = 0.0623), ERM development (P = 0.8208), postoperative CMO (P = 0.5946), tonic pupil (P > 0.9999) or corneal epithelial defects (P = N/A) were found.

CONCLUSIONS

360-degree laser retinopexy during primary PPV ± SB for RRD was associated with more complex cases and more extensive operations. Even when accounting for this, there was no difference in surgical outcomes or complication rates.

摘要

背景

确定在原发性玻璃体视网膜手术(PPV)±巩膜扣带术(SB)治疗孔源性视网膜脱离(RRD)期间使用360度激光视网膜光凝术的相关患者因素和手术因素,及其对手术结果的影响。

方法

本回顾性研究纳入了在单一中心接受PPV±SB修复非复杂性RRD的患者。主要结局为单次手术解剖成功(SSAS)。次要结局包括视力、视网膜前膜形成、黄斑囊样水肿的存在、强直性瞳孔和角膜上皮缺损。采用多因素logistic回归和多变量回归分析。

结果

该研究纳入192例病例,其中130例接受了360度激光治疗。术前logMAR视力较差(P = 0.009)、男性(P = 0.060)、增殖性玻璃体视网膜病变(PVR)分级较高、补充性SB(P = 0.0468)以及硅油/CF填塞(P < 0.0001)与使用360度激光治疗相关。未发现360度激光与SSAS(P = 0.079)、最终logMAR视力(P = 0.0623)、视网膜前膜发展(P = 0.8208)、术后黄斑囊样水肿(P = 0.5946)、强直性瞳孔(P > 0.9999)或角膜上皮缺损(P = 无可用数据)之间存在显著关联。

结论

在原发性PPV±SB治疗RRD期间进行360度激光视网膜光凝术与更复杂的病例和更广泛的手术相关。即便考虑到这一点,手术结果或并发症发生率并无差异。

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