Peck Travis J, Starr Matthew R, Yonekawa Yoshihiro, Khan M Ali, Obeid Anthony, Ryan Edwin H, Ryan Claire, Ammar Michael, Patel Luv G, Forbes Nora J, Capone Antonio, Emerson Geoffrey G, Joseph Daniel P, Eliott Dean, Regillo Carl D, Hsu Jason, Gupta Omesh P, Kuriyan Ajay E
Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA, USA.
T.J.P. and M.R.S. are first co-authors of this work.
J Vitreoretin Dis. 2021 Oct 25;6(3):194-200. doi: 10.1177/24741264211046770. eCollection 2022 May-Jun.
This work evaluates the anatomic and functional outcomes of primary rhegmatogenous retinal detachments (RRDs) with preoperative grade B and C proliferative vitreoretinopathy (PVR) vs eyes without PVR.
As a multi-institutional, interventional, retrospective study of all patients undergoing primary RRD surgical procedures from January 1, 2015, through December 31, 2015, this study evaluated the visual acuity (VA) outcomes and single-surgery anatomic success rates (SSAS) of patients with primary grade B and C PVR at the time of RRD repair.
A total of 2486 eyes underwent primary RD surgery during the study period, of which 153 eyes (6.2%) had documented preoperative PVR grade B or C. Eyes without PVR had better SSAS compared with eyes with grade B or C PVR (87% vs 83% vs 75%, respectively, < .0001). Eyes without PVR also had better final mean (SD) logMAR VA (0.35 [0.47]; 20/45 Snellen equivalent) than eyes with PVR of grade B (0.50 [0.56]; 20/63 Snellen equivalent) or grade C ( < .0001). In only eyes with preoperative PVR, there were no significant differences in final VA or SSAS on multivariate analysis based on surgical approach or use of retinectomy or membrane peeling alone in the intraoperative management of PVR.
Eyes with primary preoperative grade B and C PVR appear to have significantly worse VA outcomes and lower surgical success rates. Surgical approach and management of PVR membranes did not appear to affect VA or success rates, indicating that preoperative PVR severity may dictate these outcomes.
本研究评估术前B级和C级增殖性玻璃体视网膜病变(PVR)的原发性孔源性视网膜脱离(RRD)与无PVR的眼睛相比的解剖和功能结果。
作为一项多机构、干预性、回顾性研究,对2015年1月1日至2015年12月31日期间接受原发性RRD手术的所有患者进行研究,本研究评估了RRD修复时原发性B级和C级PVR患者的视力(VA)结果和单手术解剖成功率(SSAS)。
在研究期间,共有2486只眼睛接受了原发性视网膜脱离手术,其中153只眼睛(6.2%)记录有术前PVR B级或C级。与B级或C级PVR的眼睛相比,无PVR的眼睛具有更好的SSAS(分别为87%对83%对75%,P<0.0001)。无PVR的眼睛最终平均(标准差)logMAR视力(0.35[0.47];相当于20/45 Snellen视力)也比B级PVR(0.50[0.56];相当于20/63 Snellen视力)或C级PVR的眼睛好(P<0.0001)。仅在术前有PVR的眼睛中,基于手术方式或在PVR术中管理中单独使用视网膜切除术或膜剥离的多变量分析中,最终视力或SSAS没有显著差异。
术前原发性B级和C级PVR的眼睛似乎视力结果明显更差,手术成功率更低。PVR膜的手术方式和管理似乎不影响视力或成功率,这表明术前PVR的严重程度可能决定这些结果。