Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania; and.
Wills Eye Hospital, Glaucoma Service, Thomas Jefferson University, Philadelphia, Pennsylvania.
Retina. 2022 Nov 1;42(11):2039-2045. doi: 10.1097/IAE.0000000000003587.
To describe the prevalence, management, and outcomes of rhegmatogenous retinal detachment (RRD) after incisional glaucoma filtering surgery.
All patients with a history of trabeculectomy or glaucoma drainage device surgery who were subsequently diagnosed with an RRD from January 1, 2016, to January 1, 2021, at the Wills Eye Hospital were identified.
Forty-six eyes met the inclusion criteria. The mean age was 60.7 ± 19.6 years, and 15 patients (32.6%) were female. Of all eyes, 34 (73.9%) were diagnosed with primary open-angle glaucoma. The mean time from most recent incisional glaucoma surgery to RRD diagnosis was 1,133 ± 1,644 days. There were 19 eyes (41.3%) with preoperative proliferative vitreoretinopathy (9 eyes [19.6%] with Grade C proliferative vitreoretinopathy) and 35 eyes (76.1%) had macula-off RRD at the time of presentation. At RRD presentation, 4 eyes (8.7%) had concomitant endophthalmitis, 5 (10.9%) had concurrent choroidal detachment, and 2 (4.7%) had concurrent vitreous hemorrhage. Primary vitrectomy was performed in most (91.3%) cases. Silicone oil tamponade was often required (71.1%). The single surgery success rate was 65.2% (30 of 46). The mean preoperative logarithm of the minimum angle of resolution visual acuity was 1.72 ± 0.78 (Snellen acuity 20/1,050), and the mean final postoperative logarithm of the minimum angle of resolution was 1.59 ± 0.89 (20/778, P = 0.2853). Of glaucoma surgeries performed, the 5-year prevalence of RRD was 0.71% (26 of 3,664, 95% Poisson confidence interval 0.48%-1.04%).
The 5-year prevalence of RRDs after trabeculectomy or glaucoma drainage device was 0.71%. Most patients presented with macula-involving detachments, often with proliferative vitreoretinopathy. Anatomical and visual outcomes were poor.
描述切开性青光眼滤过手术后孔源性视网膜脱离（RRD）的患病率、处理方法和结局。
在威尔斯眼科医院，我们回顾性地分析了 2016 年 1 月 1 日至 2021 年 1 月 1 日期间所有有小梁切除术或青光眼引流装置手术史，随后被诊断为 RRD 的患者。
46 只眼符合纳入标准。平均年龄为 60.7 ± 19.6 岁，15 例（32.6%）为女性。所有眼中，34 只（73.9%）诊断为原发性开角型青光眼。从最近的切开性青光眼手术到 RRD 诊断的平均时间为 1133 ± 1644 天。19 只眼（41.3%）术前存在增殖性玻璃体视网膜病变（9 只眼[19.6%]为 C 级增殖性玻璃体视网膜病变），35 只眼（76.1%）在就诊时存在黄斑脱离的 RRD。就诊时，4 只眼（8.7%）合并眼内炎，5 只眼（10.9%）合并脉络膜脱离，2 只眼（4.7%）合并玻璃体积血。大多数（91.3%）病例行玻璃体切除术，常需硅油填充（71.1%）。单眼手术成功率为 65.2%（46 例中 30 例）。术前最小分辨角对数视力的平均 LogMAR 值为 1.72 ± 0.78（Snellen 视力 20/1050），术后最终最小分辨角对数视力的平均 LogMAR 值为 1.59 ± 0.89（20/778，P = 0.2853）。所行青光眼手术中，RRD 的 5 年患病率为 0.71%（3664 例中 26 例，95%泊松置信区间 0.48%-1.04%）。
小梁切除术或青光眼引流装置术后 5 年 RRD 的患病率为 0.71%。大多数患者出现黄斑受累的脱离，常伴有增殖性玻璃体视网膜病变。解剖和视力结果较差。
