Feist Jack E, Drummond Sean C, Fuerst Jonathan S, Crosson Jason N, Feist Richard M
University of Louisville School of Medicine, Louisville, KY, USA.
University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA.
J Vitreoretin Dis. 2024 Apr 5;8(4):388-393. doi: 10.1177/24741264241245628. eCollection 2024 Jul-Aug.
To compare the long-term outcomes of standard panretinal photocoagulation (PRP) performed in the operating room (OR) with peripheral PRP performed in the clinic in treatment-naïve patients with proliferative diabetic retinopathy (PDR). Consecutive cases from 2017 to 2022 were retrospectively reviewed. Exclusion criteria included previous PRP, pars plana vitrectomy performed at the time of the initial PRP, PRP performed in another setting within 3 months of the initial treatment, a documented plan for future PRP at the time of the initial treatment, and less than 3 years of follow-up. Negative binomial regressions were used to compare the number of subsequent interventions between the 2 groups and tests to compare the visual acuity (VA) outcomes. Of the 961 eyes of 679 patients screened, 82 eyes of 53 patients met the inclusion criteria. The initial PRP was performed in the OR (OR cohort) in 57 eyes of 38 patients and in the clinic (clinic cohort) in 25 eyes of 15 patients. The OR cohort had a mean of 0.4 subsequent surgeries and 0.8 subsequent PRP treatments and the clinic cohort, 0.8 subsequent surgeries ( < .05) and 1.8 subsequent PRP treatments ( < .05). No significant between-group difference was found in the VA outcomes over the long-term follow-up (mean, 44.2 months). Peripheral PRP performed in the OR resulted in fewer subsequent interventions than standard PRP in the clinic and may afford better control of PDR.
比较在手术室进行标准全视网膜光凝(PRP)与在诊所进行周边PRP对初治增殖性糖尿病视网膜病变(PDR)患者的长期疗效。回顾性分析2017年至2022年的连续病例。排除标准包括既往接受过PRP、初次PRP时进行过玻璃体切割术、初次治疗后3个月内在其他机构进行过PRP、初次治疗时有未来进行PRP的记录以及随访时间少于3年。采用负二项回归比较两组后续干预的次数,并进行检验以比较视力(VA)结果。在筛查的679例患者的961只眼中,53例患者的82只眼符合纳入标准。38例患者的57只眼在手术室进行初次PRP(手术室队列),15例患者的25只眼在诊所进行初次PRP(诊所队列)。手术室队列平均有0.4次后续手术和0.8次后续PRP治疗,诊所队列有0.8次后续手术(P<0.05)和1.8次后续PRP治疗(P<0.05)。在长期随访(平均44.2个月)中,两组间VA结果无显著差异。在手术室进行周边PRP比在诊所进行标准PRP导致的后续干预更少,可能对PDR有更好的控制。