Retina Service, Wills Eye Hospital, Philadelphia, PA.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
Can J Ophthalmol. 2024 Apr;59(2):e155-e160. doi: 10.1016/j.jcjo.2023.01.015. Epub 2023 Feb 16.
To identify risk factors for surgical failure after scleral buckling (SB) for primary rhegmatogenous retinal detachment (RRD) repair.
Single-centre retrospective consecutive case series.
All patients who underwent SB for repair of primary RRD at Wills Eye Hospital between January 1, 2015, and December 31, 2018, were included.
Single-surgery anatomic success (SSAS) rate and risk factors associated with surgical failure were evaluated. A multivariable logistic regression model was completed to assess the effect of demographic, clinical, and operative variables on SSAS rate.
A total of 499 eyes of 499 patients were included. Overall SSAS rate was 86% (n = 430 of 499). Using multivariate analysis, surgical failure was more likely in males (adjusted odds ratio [adjusted OR] = 2.98; 95% CI, 1.58-5.62; p = 0.0007) with a macula-off status on preoperative examination (adjusted OR = 2.15; 95% CI, 1.10-4.20; p = 0.03) and preoperative proliferative vitreoretinopathy (adjusted OR = 4.26; 95% CI, 1.10-16.5; p = 0.04). Time interval between initial examination and surgery (p = 0.26), distribution of buckle or band material used (p = 0.88), and distribution of tamponade used (p = 0.74) were not significantly different between eyes with and without surgical failure.
Male sex, macula-off status, and preoperative proliferative vitreoretinopathy were factors with increased odds of surgical failure after SB for primary RRD repair. Operative characteristics, such as type of band or use of tamponade, were not associated with surgical failure.
确定巩膜扣带术(SB)治疗原发性孔源性视网膜脱离(RRD)修复术后手术失败的风险因素。
单中心回顾性连续病例系列。
所有在 2015 年 1 月 1 日至 2018 年 12 月 31 日期间在威尔斯眼科医院接受 SB 治疗原发性 RRD 的患者均纳入本研究。
评估单手术解剖成功率(SSAS)和与手术失败相关的风险因素。采用多变量逻辑回归模型评估人口统计学、临床和手术变量对 SSAS 率的影响。
共纳入 499 例 499 只眼。总体 SSAS 率为 86%(n=430/499)。使用多变量分析,男性(调整优势比[调整 OR] = 2.98;95%可信区间,1.58-5.62;p=0.0007)、术前检查中存在黄斑脱离(调整 OR = 2.15;95%可信区间,1.10-4.20;p=0.03)和术前增殖性玻璃体视网膜病变(调整 OR = 4.26;95%可信区间,1.10-16.5;p=0.04)的患者手术失败的可能性更大。首次检查和手术之间的时间间隔(p=0.26)、使用的扣带或带材料分布(p=0.88)和使用的填塞材料分布(p=0.74)在手术成功和失败的眼中没有显著差异。
男性、黄斑脱离和术前增殖性玻璃体视网膜病变是 SB 治疗原发性 RRD 修复术后手术失败的危险因素。手术特点,如带的类型或使用的填塞物,与手术失败无关。