黄斑裂孔和玻璃体黄斑牵引行玻璃体切除术后视网膜裂孔的术中及术后风险。
Intra- and post-operative risk of retinal breaks during vitrectomy for macular hole and vitreomacular traction.
机构信息
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, United States of America.
Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States of America.
出版信息
PLoS One. 2022 Aug 11;17(8):e0272333. doi: 10.1371/journal.pone.0272333. eCollection 2022.
BACKGROUND/OBJECTIVE: To evaluate the development of intra- and post-operative retinal breaks after pars plana vitrectomy (PPV) for macular hole (MH) and/or vitreomacular traction (VMT).
SUBJECTS/METHODS: Medical records of patients who underwent PPV at Kellogg Eye Center between 1/1/2005-6/30/2018, were evaluated in three groups: group 1, MH/VMT (n = 136); group 2, epiretinal membrane (ERM) without VMT (n = 270); and group 3, diagnostic vitrectomy (DV) or vitreous opacities (n = 35). Statistical analyses were conducted using SAS.
RESULTS
20.6% of patients with MH/VMT, 8.5% of patients with ERM, and 5.7% of patients with DV or vitreous opacities had either intra-operative or post-operative breaks. Indication of MH/VMT versus ERM was a significant predictor for this outcome (p = .0112). The incidence of retinal breaks was higher in operations using 23-gauge versus 25-gauge PPV (25.0% vs. 7.4%, p < .0001).
CONCLUSIONS
The presence of MH and/or VMT is a significant risk factor for retinal breaks from PPV, as is use of 23-gauge vitrectomy.
背景/目的：评估经睫状体平坦部玻璃体切除术（PPV）治疗黄斑裂孔（MH）和/或玻璃体黄斑牵引（VMT）后，手术中及手术后视网膜裂孔的发展情况。
受试者/方法：对 2005 年 1 月 1 日至 2018 年 6 月 30 日期间在凯洛格眼科中心接受 PPV 的患者的病历进行了评估，分为三组：组 1，MH/VMT（n = 136）；组 2，无 VMT 的视网膜内膜（ERM）（n = 270）；组 3，诊断性玻璃体切除术（DV）或玻璃体混浊（n = 35）。使用 SAS 进行了统计分析。
结果
20.6%的 MH/VMT 患者、8.5%的 ERM 患者和 5.7%的 DV 或玻璃体混浊患者存在术中或术后裂孔。MH/VMT 与 ERM 的指征是该结果的显著预测因素（p =.0112）。与 25 号 PPV 相比，23 号 PPV 操作的视网膜裂孔发生率更高（25.0%比 7.4%，p <.0001）。
结论
MH 和/或 VMT 的存在是 PPV 后发生视网膜裂孔的显著危险因素，23 号玻璃体切割术的应用也是如此。
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