Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand.
Sci Rep. 2024 Aug 27;14(1):19943. doi: 10.1038/s41598-024-70898-2.
Giant retinal tear-associated rhegmatogenous retinal detachment (GRT-RRD) presents a significant surgical challenge. Trauma stands out as one of the risk factors. This retrospective case series aims to assess the outcomes of GRT-RRD patients treated with pars plana vitrectomy (PPV), distinguishing between non-trauma and blunt ocular trauma cases. The medical records and relevant retinal imaging of 60 GRT-RRD patients undergoing PPV and followed with a mean (SD) of 21.2 (13.4) months were reviewed (47 were non-trauma-related and 13 were trauma-related). Both the non-trauma and trauma groups exhibited comparable distribution of proliferative vitreoretinopathy grade (P = 0.067). Following the primary operation, there was no statistically significant difference in the proportion of patients achieving single surgery anatomical success between the non-trauma group (27/47 patients, 57.5%) and the trauma-related group (9/13 patients, 69.2%) (P = 0.534). At the final follow-up, 17 patients remained tamponade with silicone oil. Among the remaining 43 patients, 33/34 patients (97.1%) in the non-trauma group and 9/9 patients (100%) in the non-trauma group (P = 0.661) achieved comparable final surgical anatomical success. Additionally the final vision was comparable between the two trauma categories (Snellen equivalent of 20/125 for the non-trauma group and 20/200 for the trauma group, P = 0.331). In multivariable regression, no significant factors related to primary reattachment rate or final vision were identified. Non-penetrating ocular trauma did not emerge as a significant risk factor for recurrent detachment post-surgery. This study supports that PPV outcomes in GRT-RRD patients are unaffected by the ocular trauma association and reports the effectiveness of PPV in managing these patients.
巨大裂孔性视网膜脱离相关的孔源性视网膜脱离(GRT-RRD)是一项重大的手术挑战。创伤是一个重要的危险因素。本回顾性病例系列旨在评估接受玻璃体切除术(PPV)治疗的 GRT-RRD 患者的结果,将其分为非创伤性和钝性眼外伤病例。回顾了 60 例接受 PPV 治疗并平均(标准差)随访 21.2(13.4)个月的 GRT-RRD 患者的病历和相关视网膜图像(47 例与非创伤无关,13 例与创伤有关)。非创伤组和创伤组的增殖性玻璃体视网膜病变(PVR)分级分布相似(P=0.067)。初次手术后,非创伤组(27/47 例,57.5%)和创伤相关组(9/13 例,69.2%)患者单次手术解剖成功率的比例无统计学差异(P=0.534)。最终随访时,17 例患者仍用硅油填塞。在其余 43 例患者中,非创伤组 33/34 例(97.1%)和非创伤组 9/9 例(100%)(P=0.661)最终获得了相似的手术解剖成功。此外,两组的最终视力相当(非创伤组为 Snellen 等效视力 20/125,创伤组为 20/200,P=0.331)。多变量回归分析未发现与初次再附着率或最终视力相关的显著因素。非穿透性眼外伤并不是手术后复发性脱离的显著危险因素。本研究支持 PPV 治疗 GRT-RRD 患者的结果不受眼外伤的影响,并报告了 PPV 治疗这些患者的有效性。