Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiaotong University, 100 Haining Road, 200080, Shanghai, China.
BMC Ophthalmol. 2023 Feb 21;23(1):73. doi: 10.1186/s12886-023-02812-9.
This study was to compare the outcomes of 360° intra-operative laser retinopexy (ILR) and focal laser retinopexy in treating patients with pars plans vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD). To identify other potential risk factors for retinal re-detachment after primary PPV.
This was a retrospective cohort study. Three hundred and forty-four consecutive cases of primary rhegmatogenous retinal detachment treated with PPV were included between July 2013 and July 2018. Clinical characteristics and surgical outcomes were compared between focal laser retinopexy and additional 360° intra-operative laser retinopexy groups. Both univariate and multiple variable analysis were used to identify potential risk factors for retinal re-detachment.
Median follow-up was 6.2 months (Q1, Q3:2.0, 17.2). As estimated with survival analysis, the 360º ILR group had the incidence of 9.74% and focal laser 19.54% at 6 months postoperatively. At 12 months postoperatively the difference was 10.78% vs. 25.21%. The difference in survival rates was significant (p = 0.0021). In multivariate Cox regression, the risk factors for retinal re-detachment were without additional 360° ILR, diabetes and macula off before the primary surgery (relatively OR = 0.456, 95%-CI [0.245-0.848], p < 0.05; OR = 2.301, 95% CI [1.130-4.687], p < 0.05; OR = 2.243, 95% CI [1.212-4.149], p < 0.05).
Additional 360° ILR group had a significantly lower rate of retinal re-detachment when compared with focal laser retinopexy group. Our study also elucidated that diabetes and macular off before the primary surgery might also be the potential risk factors for higher rate of retinal re-detachment outcome.
This was a retrospective cohort study.
本研究旨在比较 360°术中激光视网膜光凝术（ILR）和局灶性激光视网膜光凝术治疗原发性孔源性视网膜脱离（RRD）行玻璃体切割术（PPV）患者的疗效。以明确原发性 PPV 后视网膜再脱离的其他潜在危险因素。
这是一项回顾性队列研究。纳入 2013 年 7 月至 2018 年 7 月间行 PPV 治疗的 344 例原发性孔源性视网膜脱离患者。比较局灶性激光视网膜光凝术组和附加 360°术中激光视网膜光凝术组的临床特征和手术结果。采用单因素和多变量分析确定视网膜再脱离的潜在危险因素。
中位随访时间为 6.2 个月（Q1，Q3：2.0，17.2）。生存分析估计，360°ILR 组术后 6 个月的发生率为 9.74%，局灶性激光组为 19.54%。术后 12 个月时，差异分别为 10.78%和 25.21%。生存率差异有统计学意义（p=0.0021）。多变量 Cox 回归分析显示，视网膜再脱离的危险因素为未行附加 360°ILR、糖尿病和术前黄斑脱离（相对 OR=0.456，95%CI[0.245-0.848]，p<0.05；OR=2.301，95%CI[1.130-4.687]，p<0.05；OR=2.243，95%CI[1.212-4.149]，p<0.05）。
与局灶性激光视网膜光凝术组相比，附加 360°ILR 组的视网膜再脱离率显著降低。本研究还表明，糖尿病和术前黄斑脱离也可能是视网膜再脱离发生率较高的潜在危险因素。
本研究为回顾性队列研究。
