Dumas C, Bonnet M
Clinique Ophtalmologique Universitaire B, Hôpital de la Croix-Rousse, Lyon, France.
J Fr Ophtalmol. 1996;19(6-7):455-63.
To determine whether preoperative choroidal detachment associated with primary rhegmatogenous retinal detachment is an independent risk factor for postoperative PVR.
One hundred eighty nine primary rhegmatogenous retinal detachments in 187 consecutive patients, initially operated on by the same surgeon, were enrolled in a prospective study. Ten eyes showed preoperative choroidal detachment associated with retinal detachment. Owing to the small number of eyes with preoperative choroidal detachment, we conducted the statistical analysis using the calculation of relative risk.
The correlation between preoperative choroidal detachment and preoperative PVR grade C-D was statistically significant (RR: 9.03; confidence interval: 2.91-28). Postoperative PVR occurred, or recurred, in one of the 10 eyes with preoperative choroidal detachment (10%), and 10 of the 179 eyes with no choroidal detachment (5.58%). The difference between the two groups is not statistically significant (RR: 1.79; confidence interval: 0.25-12.64). All eyes which developed postoperative PVR showed one or two recognized independent risk factors for postoperative PVR (preoperative PVR grade C-D and/or retinal tears > or = 90 degrees).
With the treatment modalities used in the present series (preoperative and postoperative steroids, and vitreoretinal microsurgery) preoperative choroidal detachment associated with primary rhegmatogenous retinal detachment no longer appears to be an independent risk factor for postoperative PVR.
确定与原发性孔源性视网膜脱离相关的术前脉络膜脱离是否是术后增殖性玻璃体视网膜病变(PVR)的独立危险因素。
187例连续患者的189只原发性孔源性视网膜脱离,最初由同一位外科医生进行手术,纳入一项前瞻性研究。10只眼显示术前脉络膜脱离与视网膜脱离相关。由于术前脉络膜脱离的眼数较少,我们使用相对危险度计算进行统计分析。
术前脉络膜脱离与术前PVR C-D级之间的相关性具有统计学意义(相对危险度:9.03;置信区间:2.91-28)。术前有脉络膜脱离的10只眼中有1只(10%)发生了术后PVR或PVR复发,无脉络膜脱离的179只眼中有10只(5.58%)发生了术后PVR或PVR复发。两组之间的差异无统计学意义(相对危险度:1.79;置信区间:0.25-12.64)。所有发生术后PVR的眼均显示出一或两个公认的术后PVR独立危险因素(术前PVR C-D级和/或视网膜裂孔≥90度)。
采用本系列中使用的治疗方式(术前和术后使用类固醇以及玻璃体视网膜显微手术),与原发性孔源性视网膜脱离相关的术前脉络膜脱离似乎不再是术后PVR的独立危险因素。