Manchester Royal Eye Hospital, Manchester, United Kingdom; and.
School of Medicine, University of Málaga, Málaga, Spain.
Retina. 2024 Mar 1;44(3):421-428. doi: 10.1097/IAE.0000000000003984.
To assess the long-term visual recovery in uncomplicated macula-off pseudophakic rhegmatogenous retinal detachment treated with pars plana vitrectomy and gas tamponade in the absence of other visual comorbidities.
Single-center retrospective longitudinal study on eyes with macula-off pseudophakic rhegmatogenous retinal detachment successfully treated with pars plana vitrectomy between 2011 and 2020 and with at least 2 follow-ups (FU), first gas-free FU (first-FU) and a final-FU, were included. Patients with subsequent ocular surgery or comorbidities affecting best-corrected visual acuity were excluded. The duration between operation date and final-FU was calculated (total days FU) and split into total days quintiles-1: ≤57, 2: >57 and ≤77, 3: >77 and ≤152, 4: >152 and ≤508, and 5: >508 days. Multivariable regression was performed with logMAR gain between the first and the final-FU as the dependent variable.
In 209 eyes, the authors report association with increase of logMAR gain between the first and the final-FU, with reducing clock hours of pseudophakic rhegmatogenous retinal detachment ( P = 0.041) and relative to the total days Quintile 1. Mean (SD) logMAR gain between the first and the final-FU was 0.02 (0.07) in the first quintile, increasing to 0.14 (0.13) ( P < 0.001) by the fifth quintile on multivariable regression. For patients not achieving 0.30 logMAR at the first-FU, this was attained at the final-FU with a sensitivity of 51.9% and specificity of 95.5% at a cut off ≤0.58 logMAR at the first-FU (area under the curve 0.756 [95% confidence interval 0.664-0.848], P < 0.001).
The authors report a significant time-dependent visual improvement after uncomplicated pars plana vitrectomy with gas tamponade for macula-off pseudophakic rhegmatogenous retinal detachment without visual confounders and provide important quantitative data for counselling patients with macula-off repair.
评估无其他视力合并症的单纯性黄斑下孔性孔源性视网膜脱离经玻璃体切除术联合硅油填充治疗后的长期视力恢复情况。
对 2011 年至 2020 年间接受玻璃体切除术治疗且至少有 2 次随访（首次无硅油随访和最终随访）的黄斑下孔性孔源性视网膜脱离患者进行单中心回顾性纵向研究。排除随后接受眼部手术或影响最佳矫正视力的合并症的患者。计算手术日期与最终随访日期之间的持续时间（随访总天数），并将其分为 5 个五分位组：1：≤57 天，2：＞57 天且≤77 天，3：＞77 天且≤152 天，4：＞152 天且≤508 天，5：＞508 天。将首次随访和最终随访之间的 logMAR 增益作为因变量，进行多变量回归分析。
在 209 只眼中，作者报告了与首次和最终随访之间 logMAR 增益增加相关的结果，与假性孔源性视网膜脱离的时钟小时数减少（P = 0.041）和与总随访天数第 1 个五分位组相关。在第一个五分位组中，首次随访和最终随访之间的 logMAR 增益平均值（标准差）为 0.02（0.07），在第 5 个五分位组中增加至 0.14（0.13）（P <0.001）。对于在首次无硅油随访时未达到 0.30 logMAR 的患者，在最终随访时达到了这一目标，在首次无硅油随访时 logMAR 增益≤0.58 时的敏感性为 51.9%，特异性为 95.5%（曲线下面积 0.756 [95%置信区间 0.664-0.848]，P <0.001）。
作者报告了在无其他视力合并症的情况下，单纯性玻璃体切除术联合硅油填充治疗黄斑下孔性孔源性视网膜脱离后，视力随时间显著改善，并为黄斑下修复患者提供了重要的定量数据。
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