Department of Ophthalmology, Kim's Eye Hospital, #156 Youngdeungpo-dong 4ga, Youngdeungpo-gu, Seoul, 150-034, South Korea.
BMC Ophthalmol. 2023 Jun 19;23(1):282. doi: 10.1186/s12886-023-03030-z.
Information regarding incidence of treatment plan changes may be useful when discussing postoperative treatment plans for patients. Moreover, it may help establish a standardized postoperative treatment plan. This study aimed to evaluate the incidence of early complications requiring treatment plan changes in patients following vitreoretinal surgery and investigate its risk factors.
This single-center retrospective study included 465 patients who had undergone vitreoretinal surgery. The reasons, incidence, and timing of treatment plan changes within 14 days of surgery were identified. Potential factors associated with the changes, such as patient demographics, surgeon's experience, diagnoses, and type of surgery were also analyzed.
The treatment plan was changed in 76 patients (16.3%) at a mean of 4.0 ± 3.2 days after vitreoretinal surgery. The reasons for the plan changes were increased intraocular pressure (IIOP) in 66(86.8%), intraocular inflammation in 2(2.6%), corneal edema in 3(3.9%), leakage from the sclerotomy wound in 3(3.9%) patients, and combined IIOP and intraocular inflammation in 2(2.6%). The date of discharge was postponed because of treatment plan changes in 17 patients (22.4%). The incidence of plan changes was higher in patients who underwent gas or oil tamponade (P < 0.001) and those who underwent surgery performed by less experienced surgeons (P = 0.034).
Treatment plan was changed in 16.3% of patients after vitreoretinal surgery. The risk of treatment plan changes was associated with the surgeon's experience in vitreoretinal surgery and the type of surgery. These results should be considered when establishing standardized care plans for patients who require vitreoretinal surgery.
在讨论玻璃体视网膜手术后患者的术后治疗方案时，了解治疗方案变更的发生率可能会有所帮助。此外，它还有助于建立标准化的术后治疗方案。本研究旨在评估玻璃体视网膜手术后患者早期需要治疗方案变更的并发症发生率，并探讨其危险因素。
这是一项单中心回顾性研究，共纳入 465 名接受玻璃体视网膜手术的患者。确定手术 14 天内治疗方案变更的原因、发生率和时间。还分析了与变更相关的潜在因素，如患者人口统计学特征、医生经验、诊断和手术类型。
76 名患者（16.3%）在玻璃体视网膜手术后平均 4.0±3.2 天更改了治疗方案。变更计划的原因是眼压升高（IOP）在 66 例（86.8%）、眼内炎症 2 例（2.6%）、角膜水肿 3 例（3.9%）、巩膜切口漏 3 例（3.9%）和眼压升高伴眼内炎症 2 例（2.6%）。由于治疗方案的改变，17 名患者（22.4%）的出院日期被推迟。气液或硅油填充的患者（P<0.001）和经验较少的医生进行手术的患者（P=0.034）变更计划的发生率更高。
玻璃体视网膜手术后 16.3%的患者需要更改治疗方案。治疗方案变更的风险与玻璃体视网膜手术医生的经验和手术类型有关。在为需要玻璃体视网膜手术的患者制定标准化护理计划时，应考虑这些结果。
