Duquesne N, Bonnet M, Adeleine P
Clinique Ophthalmologique universitaire B, UFR Lyon Nord, Hôpital de la Croix-Rousse, Lyon, France.
Graefes Arch Clin Exp Ophthalmol. 1996 Nov;234(11):677-82. doi: 10.1007/BF00292353.
We conducted a prospective clinical study to elucidate the role of preoperative vitreous hemorrhage in the development of postoperative proliferative vitreoretinopathy (PVR) in primary rhegmatogenous retinal detachment.
We prospectively evaluated 409 eyes of 390 patients affected by primary rhegmatogenous retinal detachment referred before any failed attempt to reattach the retina. Single and multiple logistic regression analysis were used to test 14 categories of variables.
Postoperative PVR occurred in 48 (11.7% of 409 eyes). Postoperative PVR developed in 41 (11.8%) of the 347 eyes with no preoperative vitreous hemorrhage, and 7 (11.3%) of the 62 eyes with preoperative vitreous hemorrhage (P = 0.90). The results of multiple logistic regression analysis showed that only four variables were significant factors which had independently and jointly an effect on the risk of postoperative PVR: (1) 90 degrees or greater circumferential extent of the retinal tears; (2) preoperative PVR grade B; (3) preoperative PVR grade C-D; and (4) the use of cyrotreatment as the method of retinopexy.
With the surgical techniques currently used, mild preoperative vitreous hemorrhage is not an independent risk factor for postoperative PVR in primary rhegmatogenous retinal detachment. The role of moderate and severe vitreous hemorrhage remains to be fully evaluated in a larger series of eyes.
我们进行了一项前瞻性临床研究,以阐明术前玻璃体出血在原发性孔源性视网膜脱离术后增生性玻璃体视网膜病变(PVR)发生中的作用。
我们前瞻性评估了390例原发性孔源性视网膜脱离患者的409只眼,这些患者在任何视网膜复位失败尝试之前前来就诊。采用单因素和多因素逻辑回归分析来检验14类变量。
术后PVR发生在48只眼(占409只眼的11.7%)。347只无术前玻璃体出血的眼中有41只(11.8%)发生了术后PVR,62只术前有玻璃体出血的眼中有7只(11.3%)发生了术后PVR(P = 0.90)。多因素逻辑回归分析结果显示,只有四个变量是对术后PVR风险有独立且共同影响的显著因素:(1)视网膜裂孔的圆周范围为90度或更大;(2)术前PVR B级;(3)术前PVR C - D级;(4)使用冷冻疗法作为视网膜固定术的方法。
就目前使用的手术技术而言,轻度术前玻璃体出血不是原发性孔源性视网膜脱离术后PVR的独立危险因素。中重度玻璃体出血的作用仍有待在更大系列的眼中进行全面评估。