Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, China.
Aier Eye Hospital of Wuhan University, No.481 Zhongshan Road, Wuchang District, Wuhan, China.
Sci Rep. 2022 May 12;12(1):7916. doi: 10.1038/s41598-022-12154-z.
To detect the prognostic factors associated with initial reattachment after primary pars plana vitrectomy (PPV) with air tamponade for rhegmatogenous retinal detachment (RRD). We retrospectively reviewed 92 eyes of 92 patients with RRD. All eyes underwent PPV with air tamponade and a follow-up of at least 6 months. Initial anatomical success was defined as reattachment of the retina by a single operation. We performed univariate analysis to detect the presence of any difference between eyes with a successful initial reattachment and those that failed. We also performed multivariate logistic regression analysis to assess the influence of each preoperative factor on initial success. The rate of initial reattachment success was 93.5%. The percentage of retinal detachment involving the inferior quadrants in the initial success group was less than that in the initial failure group, and the difference was statistically significant (P = 0.043). There were no significant differences noted for other factors, such as symptom duration (P = 0.078) or location of retinal breaks (P = 0.065). Multiple logistic regression analysis using preoperative factors indicated that older age (odds ratio, 0.90; 95% confidence interval, 0.82-0.97; P = 0.010) and non-involvement of inferior quadrants (odds ratio, 9.90; 95% confidence interval, 1.36-71.92; P = 0.023) were significantly associated with initial success. PPV combined with air may be an effective treatment for some simple RRDs (proliferative vitreoretinopathy [PVR] grade ≤ C1). Non-involvement of the inferior quadrants and older age at presentation are associated with a greater likelihood of anatomic success. The volume of air in the eye after surgery is also very important, which may also affect the reduction of retinal detachment.
为了检测与原发性经睫状体平坦部玻璃体切除术(PPV)联合空气填充治疗孔源性视网膜脱离(RRD)后初次复位相关的预后因素。我们回顾性分析了 92 例 92 只眼的 RRD 患者。所有患者均接受了 PPV 联合空气填充,并进行了至少 6 个月的随访。初次解剖学成功定义为单次手术视网膜复位。我们进行单因素分析以检测初次复位成功眼与复位失败眼之间是否存在差异。我们还进行了多变量逻辑回归分析,以评估每个术前因素对初次成功的影响。初次复位成功率为 93.5%。初次复位成功组中累及下方象限的视网膜脱离百分比小于初次复位失败组,差异有统计学意义(P=0.043)。其他因素,如症状持续时间(P=0.078)或视网膜裂孔位置(P=0.065),差异无统计学意义。使用术前因素进行多变量逻辑回归分析表明,年龄较大(优势比,0.90;95%置信区间,0.82-0.97;P=0.010)和下方象限无累及(优势比,9.90;95%置信区间,1.36-71.92;P=0.023)与初次成功显著相关。PPV 联合空气可能是治疗某些简单 RRD(增殖性玻璃体视网膜病变[PVR]等级≤C1)的有效方法。下方象限无累及和发病时年龄较大与解剖学成功的可能性更大相关。术后眼内空气的体积也非常重要,这也可能影响视网膜脱离的减少。