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硅油填充巩膜外加压术后孔源性视网膜脱离复发。

Recurrent retinal detachment after pars plana vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment.

机构信息

Department of Ophthalmology, Baoding NO. 1 Central Hospital, Baoding, 071000, Hebei Province, China.

Affiliated Hospital of Hebei University, Baoding, 071000, Hebei Province, China.

出版信息

Int Ophthalmol. 2022 Dec;42(12):3813-3820. doi: 10.1007/s10792-022-02401-7. Epub 2022 Jul 8.

Abstract

BACKGROUND

The recurrence of retinal detachment following rhegmatogenous retinal detachment (RRD) is a relatively common complication that can lead to reduced visual acuity and requires further surgery. The purpose of this study was to investigate the risk factors and visual outcomes of recurrent RRD following pars plana vitrectomy (PPV) with silicone oil tamponade for primary RRD.

METHODS

This was a retrospective follow-up study of 343 eyes that underwent initial PPV surgery with silicone oil tamponade for primary RRD. Patients were divided into a recurrence group and a reattachment group. The main outcome measures included causative factors, visual outcomes related to the recurrence of RRD, and the perioperative factors most affecting the recurrence of RRD.

RESULTS

After retinal reattachment, we observed RRD recurrence after PPV for primary RRD in 42 out of 343 eyes (12.2%) during the follow-up period. Most causes of recurrence (69%) occurred within 6 months of surgery. Multivariate logistic regression analysis showed that a PVR ≥ Grade C (odds ratio [OR]: 4.015; 95% confidence interval [CI] 1.721-9.367; P = 0.001) was a significant predictor for the development of recurrent RRD. Compared with the reattachment group, the recurrence group exhibited a significant decline in best-corrected visual acuity (BCVA) at the last follow-up visit (P = 0.000). Eyes with PVR prior to primary surgery, or at the diagnosis of re-detachment, showed a worse final BCVA.

CONCLUSIONS

Our analysis shows that the predominant risk factor for the recurrence of RRD is a PVR ≥ Grade C. PVR prior to primary surgery, or at the diagnosis of re-detachment, was also shown to limit the recovery of final visual acuity.

摘要

背景

孔源性视网膜脱离(RRD)复位后复发是一种较为常见的并发症,可导致视力下降,需要进一步手术。本研究旨在探讨硅油填充玻璃体切割术(PPV)治疗原发性 RRD 后 RRD 复发的危险因素和视力结果。

方法

这是一项对 343 例接受初始 PPV 手术联合硅油填充治疗原发性 RRD 的患者进行的回顾性随访研究。患者分为复发组和再附着组。主要观察指标包括复发的原因、与 RRD 复发相关的视力结果以及影响 RRD 复发的围手术期因素。

结果

在 343 只眼的随访中,有 42 只眼(12.2%)在接受原发性 RRD 的 PPV 治疗后出现视网膜脱离复发。大多数复发原因(69%)发生在手术后 6 个月内。多因素 logistic 回归分析显示,PVR≥C 级(优势比[OR]:4.015;95%置信区间[CI]:1.721-9.367;P=0.001)是 RRD 复发的显著预测因素。与再附着组相比,复发组在末次随访时最佳矫正视力(BCVA)明显下降(P=0.000)。初次手术前或再脱离时存在 PVR 的眼,最终 BCVA 更差。

结论

我们的分析表明,RRD 复发的主要危险因素是 PVR≥C 级。初次手术前或再脱离时存在 PVR 也会限制最终视力的恢复。

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