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单纯性视网膜脱离修复术后视网膜前膜手术的时机

Timing of Epiretinal Membrane Surgery After Uncomplicated Retinal Detachment Repair.

作者信息

Bomdica Prithvi R, Shepherd E Anne, Gupta Rishabh, Chaturvedi Vivek

机构信息

Department of Ophthalmology, Rush University Medical Center, Chicago, IL, USA.

Illinois Retina Associates, Chicago, IL, USA.

出版信息

J Vitreoretin Dis. 2025 May 15:24741264251337107. doi: 10.1177/24741264251337107.

Abstract

To evaluate the features and outcomes of postoperative epiretinal membranes (ERMs) after retinal detachment (RD) repair based on the timing of macular peeling (MP). This retrospective consecutive case series comprised patients who had rhegmatogenous RD repair, developed an ERM, and had MP within 1 year. Of the ERMs, 91% (50/55) were diagnosed between 1 month and 3 months after RD repair. When MP was performed less than 6 months after RD repair (n = 37), the final logMAR visual acuity (VA) was 0.31; this was statistically better than when MP was performed 6 months after RD repair or later (0.63, n = 18) ( = .005). In the 6-months or later MP cohort, 61% (11/18) had cataract surgery between the RD repair and MP while 7 patients were pseudophakic at RD presentation. Of the ERMs, 65%, 24%, and 11% were stage 4, stage 3, and stage 2, respectively; the final logMAR VA was 0.43, 0.38, and 0.30, respectively. There was no significant difference in the final VA or macular status between the stages. Overall, the mean logMAR VA before MP was 0.87, which improved to a final VA of 0.41 after MP ( < .001). ERMs formed after RD repair were most likely to be stage 4; however, this did not affect the final VA. The final VA was significantly better when MP was performed less than 6 months after RD repair. This is relevant because retina surgeons may be delaying MP until after cataract surgery.

摘要

基于黄斑剥除(MP)的时机评估视网膜脱离(RD)修复术后视网膜前膜(ERM)的特征及预后。本回顾性连续病例系列研究纳入了行孔源性RD修复术、术后发生ERM且在1年内接受MP的患者。在这些ERM患者中,91%(50/55)在RD修复术后1个月至3个月被诊断出来。当MP在RD修复术后不到6个月进行时(n = 37),最终的logMAR视力(VA)为0.31;这在统计学上优于MP在RD修复术后6个月或更晚进行时的情况(0.63,n = 18)(P = 0.005)。在MP在6个月或更晚进行的队列中,61%(11/18)在RD修复术和MP之间接受了白内障手术,而7例患者在RD发病时为人工晶状体眼。在ERM中,65%、24%和11%分别为4期、3期和2期;最终的logMAR VA分别为0.43、0.38和0.30。各期之间的最终视力或黄斑状态无显著差异。总体而言,MP前的平均logMAR VA为0.87,MP后改善至最终VA为0.41(P < 0.001)。RD修复术后形成的ERM最可能为4期;然而,这并不影响最终视力。当MP在RD修复术后不到6个月进行时,最终视力明显更好。这一点很重要,因为视网膜外科医生可能会将MP推迟到白内障手术后进行。

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