Department of Ophthalmology, Angers University Hospital, Angers University, Angers, France.
Department of Ophthalmology, Nantes University Hospital, Nantes University, Nantes, France.
Eye (Lond). 2024 Dec;38(17):3325-3333. doi: 10.1038/s41433-024-03300-0. Epub 2024 Sep 6.
BACKGROUND/OBJECTIVES: The predictive factors of surgical results in uveitic retinal detachment (RD) are lacking. The objective was to study the surgical outcomes and determine the risk factors for surgical failure in rhegmatogenous RD associated with intraocular inflammation (RRDIOI).
Retrospective series of consecutive eyes with RRDIOI undergoing vitreoretinal surgery between 2012 and 2019 in two French referral centres. Patients underwent 23- or 25 G pars plana vitrectomy (PPV), scleral buckling (SB), or a combination of both. The main objective was to describe the predictive factors of visual recovery and anatomical success after surgery.
Seventy-one eyes were included. Posterior and panuveitis accounted for 91.5% of eyes. Seventy-five percent of eyes had an infectious cause for their uveitis. The first surgery consisted in PPV alone, SB alone, or both in 87.3%, 4.2% and 8.5% of cases respectively. The reattachment rate was 74.6% after one surgery (100% in case of SB, either alone or in association with PPV). On multivariate analysis, the only predictive factor of visual improvement was a baseline BCVA ≥ 20/400, while the only predictive factor for surgical success at 12 months was the absence of RD recurrence within the first 6 weeks of surgery.
RRDIOI has a relatively favourable anatomical prognosis. The addition of scleral buckling may be beneficial in selected cases.
背景/目的：葡萄膜炎相关视网膜脱离（RRD）的手术结果预测因素尚不清楚。本研究旨在探讨与眼内炎症相关的孔源性 RRD（RRDIOI）的手术结果，并确定手术失败的风险因素。
这是一项回顾性系列研究，纳入了 2012 年至 2019 年期间在法国两个转诊中心接受玻璃体视网膜手术的连续 RRDIOI 患者。患者接受了 23G 或 25G 经睫状体平坦部玻璃体切除术（PPV）、巩膜扣带术（SB）或两者联合治疗。主要目的是描述手术后视力恢复和解剖成功的预测因素。
共纳入 71 只眼。后葡萄膜炎和全葡萄膜炎分别占 91.5%。75%的眼因眼内炎症而出现感染。第一次手术分别采用单纯 PPV、单纯 SB 或两者联合治疗，占比分别为 87.3%、4.2%和 8.5%。一次手术后的再附着率为 74.6%（SB 单独或与 PPV 联合治疗的成功率为 100%）。多变量分析显示，视力改善的唯一预测因素是基线 BCVA≥20/400，而 12 个月时手术成功的唯一预测因素是手术 6 周内无 RD 复发。
RRDIOI 具有相对较好的解剖学预后。在某些情况下，添加巩膜扣带术可能有益。
