Abstract：
To investigate factors associated with good visual acuity (VA) following repair of rhegmatogenous retinal detachments (RD) with proliferative vitreoretinopathy (PVR) undergoing retinectomy.
Interventional, retrospective, case-control study.
This single-institution study evaluated patients who underwent retinectomy during repair of RD with PVR from January 1, 2015 to December 31, 2019. A good VA cohort was identified based on a final VA ≥20/70. A 2:1 age-matched and gender-matched poor VA cohort with VA <20/70 was subsequently identified. Metrics compared between the two cohorts included time from primary and recurrent RD diagnosis to surgery, lens status, initial RD size, macula involvement, PVR grade, and size of retinectomy.
A total of 5355 eyes were diagnosed with primary RD during the study period, of which 345 had PVR and underwent retinectomy. The good VA cohort included 62 eyes with a mean final logMAR VA of 0.32 [Snellen 20/42], while the poor VA cohort included 119 eyes with a mean final logMAR VA of 1.54 [Snellen 20/693; P < .0001]. On multivariate analysis, smaller initial RD size (P = .0090), fewer surgeries (P = .0002), shorter time between recurrent RD diagnosis and subsequent surgeries (P = .0006), better preoperative VA (P = .0276), and pseudophakia at final visit (P = .0049) remained significant predictors of good vision.
Eyes undergoing retinectomy during repair of RD with PVR can achieve good VA outcomes. The primary modifiable factor associated with better VA was shorter delay between redetachment diagnosis and surgery, particularly in the absence of silicone oil tamponade.
Interventional, retrospective, case-control study.
This single-institution study evaluated patients who underwent retinectomy during repair of RD with PVR from January 1, 2015 to December 31, 2019. A good VA cohort was identified based on a final VA ≥20/70. A 2:1 age-matched and gender-matched poor VA cohort with VA <20/70 was subsequently identified. Metrics compared between the two cohorts included time from primary and recurrent RD diagnosis to surgery, lens status, initial RD size, macula involvement, PVR grade, and size of retinectomy.
A total of 5355 eyes were diagnosed with primary RD during the study period, of which 345 had PVR and underwent retinectomy. The good VA cohort included 62 eyes with a mean final logMAR VA of 0.32 [Snellen 20/42], while the poor VA cohort included 119 eyes with a mean final logMAR VA of 1.54 [Snellen 20/693; P < .0001]. On multivariate analysis, smaller initial RD size (P = .0090), fewer surgeries (P = .0002), shorter time between recurrent RD diagnosis and subsequent surgeries (P = .0006), better preoperative VA (P = .0276), and pseudophakia at final visit (P = .0049) remained significant predictors of good vision.
Eyes undergoing retinectomy during repair of RD with PVR can achieve good VA outcomes. The primary modifiable factor associated with better VA was shorter delay between redetachment diagnosis and surgery, particularly in the absence of silicone oil tamponade.
摘要：
目的探讨增生性玻璃体视网膜病变(PVR)行视网膜切除术修复血源性视网膜脱离(RD)后视力良好(VA)的相关因素。
介入性,回顾性,病例对照研究。
这项单机构研究评估了2015年1月1日至2019年12月31日用PVR修复RD期间接受视网膜切除术的患者。根据最终VA≥20/70确定了良好的VA队列。随后鉴定出2:1年龄匹配和性别匹配的不良VA队列,其VA<20/70。两个队列之间的指标比较包括从原发性和复发性RD诊断到手术的时间，镜头状态,初始RD大小，黄斑受累,PVR级,和视网膜切除术的大小。
在研究期间共有5355只眼被诊断为原发性RD，其中345例患有PVR并接受了视网膜切除术。良好的VA队列包括62只眼，平均最终logMARVA为0.32[Snellen20/42]，而不良VA队列包括119只眼，平均最终logMARVA为1.54[Snellen20/693;P<.0001]。在多变量分析中，较小的初始RD大小(P=.0090)，手术次数较少（P=.0002），复发性RD诊断与后续手术之间的时间较短（P=.0006），术前更好的VA（P=0.0276），最后一次就诊时的假晶状体眼（P=.0049）仍然是良好视力的重要预测因素。
在使用PVR修复RD期间行视网膜切除术的眼睛可以获得良好的VA结果。与更好的VA相关的主要可改变因素是在再脱离诊断和手术之间的延迟较短，特别是在没有硅油填塞的情况下。
介入性,回顾性,病例对照研究。
这项单机构研究评估了2015年1月1日至2019年12月31日用PVR修复RD期间接受视网膜切除术的患者。根据最终VA≥20/70确定了良好的VA队列。随后鉴定出2:1年龄匹配和性别匹配的不良VA队列,其VA<20/70。两个队列之间的指标比较包括从原发性和复发性RD诊断到手术的时间，镜头状态,初始RD大小，黄斑受累,PVR级,和视网膜切除术的大小。
在研究期间共有5355只眼被诊断为原发性RD，其中345例患有PVR并接受了视网膜切除术。良好的VA队列包括62只眼，平均最终logMARVA为0.32[Snellen20/42]，而不良VA队列包括119只眼，平均最终logMARVA为1.54[Snellen20/693;P<.0001]。在多变量分析中，较小的初始RD大小(P=.0090)，手术次数较少（P=.0002），复发性RD诊断与后续手术之间的时间较短（P=.0006），术前更好的VA（P=0.0276），最后一次就诊时的假晶状体眼（P=.0049）仍然是良好视力的重要预测因素。
在使用PVR修复RD期间行视网膜切除术的眼睛可以获得良好的VA结果。与更好的VA相关的主要可改变因素是在再脱离诊断和手术之间的延迟较短，特别是在没有硅油填塞的情况下。
