Girard P, Karpouzas I, Saade G
Service du Dr S, Morax, Fondation Ophthalmologique Rothschild, Paris.
J Fr Ophtalmol. 1996;19(5):335-40.
To report the prevalence and visual outcome of macular pucker occurring after retinal detachment surgery, and to analyze its risk factors.
We retrospectively studied 865 cases of retinal detachment that had been successfully treated in the absence of macular hole or proliferative vitreoretinopathy higher than grade C1. For the statistical analysis, 63 variables were submitted to CHI-square test.
Macular pucker occurred in 68 cases (7.7%). Final visual acuity was 0.5 or better in 24 cases, spontaneously in 7 and after macular surgery in 17. In 6 other cases, macular pucker was much less important in terms of visual impairment than coexisting amblyopia or other posterior pole pathology. In the 38 remaining cases, macular pucker was the cause of visual failure, despite macular surgery in 9 of them. Retinal detachment recurred after macular surgery in 2/26 cases. Nine variables were found to correlate with an increased risk of macular pucker: emmetropia, hyperopia, preoperative acuity reduced to light perception-hand movement, macula off, preoperative proliferative vitreoretinopathy (grade B or C1), retinal tears up to 30 degrees, retinal tears larger than 30 degrees, and cumulative retinal break area larger than 3 disks.
Our results show that macular surgery can be useful in case of macular pucker after retinal detachment surgery. They also suggest that macular pucker and proliferative vitreoretinopathy have some risk factors in common.
报告视网膜脱离手术后黄斑皱襞的发生率及视力转归，并分析其危险因素。
我们回顾性研究了865例成功治疗的视网膜脱离病例，这些病例不存在黄斑裂孔或C1级以上的增生性玻璃体视网膜病变。为进行统计分析，对63个变量进行了卡方检验。
68例（7.7%）发生黄斑皱襞。最终视力达到或优于0.5的有24例，其中7例自发改善，17例在黄斑手术后改善。另外6例中，黄斑皱襞对视功能的损害远小于同时存在的弱视或其他后极部病变。其余38例中，黄斑皱襞是视力下降的原因，其中9例接受了黄斑手术。黄斑手术后2/26例视网膜脱离复发。发现9个变量与黄斑皱襞风险增加相关：正视、远视、术前视力降至光感-手动，黄斑脱离，术前增生性玻璃体视网膜病变（B级或C1级），视网膜裂孔达30度，视网膜裂孔大于30度，以及累计视网膜裂孔面积大于3个视盘。
我们的结果表明，视网膜脱离手术后发生黄斑皱襞时，黄斑手术可能有效。结果还提示，黄斑皱襞和增生性玻璃体视网膜病变有一些共同的危险因素。
