Girard P, Mimoun G, Karpouzas I, Montefiore G
Fondation Ophtalmologique Rothschild, Hôpital Saint-Antoine, Paris, France.
Retina. 1994;14(5):417-24. doi: 10.1097/00006982-199414050-00005.
To identify the clinical risk factors for the development of severe proliferative vitreoretinopathy (PVR) after retinal detachment surgery.
A retrospective study of 1020 patients with either no PVR or with PVR of grade C1 or less at initial examination was conducted. After surgery, severe PVR was defined as grade C2 or worse. The data relating to 94 variables were evaluated by univariate analysis and stepwise logistic regression.
Severe PVR developed after surgery in 107 patients (10.5%). Ten significant predictive variables were identified: minor intra- or postoperative hemorrhage, grade A preoperative PVR, preoperative choroidal detachment, giant tears, air tamponade, detachment involving more than 2 quadrants, cumulative break area larger than 3 optic disks, postoperative choroidal detachment, signs of uveitis at initial examination, and grade B preoperative PVR.
The results indicate that in addition to the size of breaks, extent of detachment, and presence of preoperative inflammation or low-grade PVR, iatrogenic problems also are important factors in the pathogenesis of severe PVR after surgery for retinal detachment.
确定视网膜脱离手术后发生严重增生性玻璃体视网膜病变（PVR）的临床危险因素。
对1020例初诊时无PVR或PVR为C1级及以下的患者进行回顾性研究。术后，严重PVR定义为C2级或更差。通过单因素分析和逐步逻辑回归对94个变量的数据进行评估。
107例患者（10.5%）术后发生严重PVR。确定了10个显著的预测变量：术中或术后少量出血、术前A 级PVR、术前脉络膜脱离、巨大裂孔、气体填塞、累及超过2个象限的脱离、累计裂孔面积大于3个视盘、术后脉络膜脱离、初诊时葡萄膜炎体征和术前B级PVR。
结果表明，除了裂孔大小、脱离范围以及术前炎症或低度PVR的存在外，医源性问题也是视网膜脱离手术后严重PVR发病机制中的重要因素。
