Awan Muhammad Amer, Hussain Syed Zohaib Maroof, Shaheen Fiza, Humayun Mian Bilal, Zeb Nain Tara, Ayub Bushra, Siddiqui M A Rehman
Ophthalmology, Shifa International Hospital, Islamabad, PAK.
Ears, Nose, and Throat, Norfolk and Norwich University Hospital, Norwich, GBR.
Cureus. 2022 Mar 24;14(3):e23437. doi: 10.7759/cureus.23437. eCollection 2022 Mar.
Introduction This study aims to evaluate the primary anatomical success and visual outcomes of 25-gauge pars plana vitrectomy (25g PPV) in patients with rhegmatogenous retinal detachment (RRD) in Pakistan. Design This is a five-year retrospective, interventional cohort study conducted at tertiary care hospitals in Pakistan from October 2013 to October 2018. Methods This is a retrospective, interventional cohort study of 418 consecutive patients with RRD who underwent 25g PPV. All surgeries were performed by two experienced surgeons at tertiary care hospitals in Pakistan. Consecutive patients who underwent 25g PPV surgery as the treatment for RRD from October 2013 to October 2018 were included. We excluded patients who had a history of previous retinal surgery or did not complete the 4-8 weeks of primary outcome visit. We used the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM Corporation, Armonk, NY, USA) for statistical analysis. A p-value of <0.05 was considered significant. Results We identified 452 patients through the coding system of our hospitals who underwent 25g PPV surgery for RRD during the study period. A total of 441 patient files were reviewed for the study, of which 418 patients met the criteria for final analysis. The mean age was 49 ± 15.8 years. There was a higher number of males (n = 284, 67.9%). In our study, 186 (44.4%) patients were phakic at the time of presentation. The macula was detached in 361 (86.4%) patients. At the primary outcome visit (4-8 weeks of follow-up), the primary anatomical success rate was 89.47%. The most common cause of failure was proliferative vitreoretinopathy (PVR) (n = 20), followed by missed breaks (n = 5). Conclusions The surgical outcomes of RRD with 25g PPV surgery in our study were similar to the outcomes reported in the developed world. We propose a prospective multicenter national study to prospectively evaluate the risk factors for RRD surgical failure in the Pakistani population.
引言 本研究旨在评估25G玻璃体切除术（25g PPV）治疗巴基斯坦孔源性视网膜脱离（RRD）患者的初步解剖学成功率和视觉效果。
设计 这是一项为期五年的回顾性干预队列研究，于2013年10月至2018年10月在巴基斯坦的三级医疗机构进行。
方法 这是一项对418例连续接受25g PPV手术的RRD患者进行的回顾性干预队列研究。所有手术均由巴基斯坦三级医疗机构的两名经验丰富的外科医生进行。纳入2013年10月至2018年10月期间连续接受25g PPV手术治疗RRD的患者。我们排除了既往有视网膜手术史或未完成主要结局随访4 - 8周的患者。我们使用社会科学统计软件包（SPSS）23.0版（美国纽约州阿蒙克市IBM公司）进行统计分析。p值<0.05被认为具有统计学意义。
结果 通过我们医院的编码系统，我们确定了452例在研究期间接受25g PPV手术治疗RRD的患者。本研究共审查了441份患者档案，其中418例患者符合最终分析标准。平均年龄为49±15.8岁。男性患者数量较多（n = 284，67.9%）。在我们的研究中，186例（44.4%）患者就诊时晶状体在位。361例（86.4%）患者黄斑脱离。在主要结局随访（4 - 8周）时，初步解剖学成功率为89.47%。最常见的失败原因是增殖性玻璃体视网膜病变（PVR）（n = 20），其次是遗漏裂孔（n = 5）。
结论 我们研究中25g PPV手术治疗RRD的手术效果与发达国家报道的结果相似。我们提议开展一项前瞻性多中心全国性研究，以前瞻性评估巴基斯坦人群RRD手术失败的危险因素。
