Qian Yuan-Jie, Xiang Wu, Sun Yi-Meng, Mijit Alfira, Jiang Zhi-Hao, Wei Yan-Tao
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China.
Int J Ophthalmol. 2023 Jul 18;16(7):1110-1116. doi: 10.18240/ijo.2023.07.16. eCollection 2023.
To determine the incidence and predictive factors for epiretinal membrane (ERM) formation in eyes with complicated primary rhegmatogenous retinal detachment (RRD) tamponaded with silicone oil (SO).
This retrospective case-control study included 141 consecutive patients with (51 eyes) and without (90 eyes) ERM formation after primary pars plana vitrectomy (PPV) and SO tamponade for complicated RRD. The risk factors for ERM were assessed using logistic regression analysis.
The prevalence of postoperative ERM was 36.2% (51/141). Multivariate logistic regression analysis showed that the risk factors for ERM in SO-tamponaded eyes included preoperative proliferative vitreoretinopathy [PVR; odds ratio (OR), 2.578; 95% confidence interval (CI) 1.580-4.205, <0.001], preoperative choroidal detachment (OR, 4.454; 95%CI 1.369-14.498, =0.013), and photocoagulation energy (OR, 2.700; 95%CI 1.047-6.962, =0.040). The duration of the preoperative symptoms, intraocular SO tamponade time, giant retinal tear, preoperative vitreous hemorrhage, preoperative best-corrected visual acuity, number of breaks, quadrants of RRD, axial length, and photocoagulation points were not predictive factors for ERM formation.
Preoperative PVR, choroidal detachment, and photocoagulation energy are risk factors of ERM formation after complicated RRD repair. Better ophthalmic care as well as patient education are necessary for such patients with risk factors.
确定硅油（SO）填充的复杂性原发性孔源性视网膜脱离（RRD）眼视网膜前膜（ERM）形成的发生率及预测因素。
这项回顾性病例对照研究纳入了141例连续接受复杂性RRD的玻璃体切割联合SO填充手术的患者，其中51只眼发生ERM，90只眼未发生ERM。采用逻辑回归分析评估ERM的危险因素。
术后ERM的发生率为36.2%（51/141）。多因素逻辑回归分析显示，SO填充眼ERM的危险因素包括术前增殖性玻璃体视网膜病变[PVR；优势比（OR），2.578；95%置信区间（CI）1.580 - 4.205，P<0.001]、术前脉络膜脱离（OR，4.454；95%CI 1.369 - 14.498，P = 0.013）和光凝能量（OR，2.700；95%CI 1.047 - 6.962，P = 0.040）。术前症状持续时间、眼内SO填充时间、巨大视网膜裂孔、术前玻璃体出血、术前最佳矫正视力、裂孔数量、RRD象限、眼轴长度和光凝点数不是ERM形成的预测因素。
术前PVR、脉络膜脱离和光凝能量是复杂性RRD修复术后ERM形成的危险因素。对于具有这些危险因素的患者，需要更好的眼科护理和患者教育。
