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Abstract：
Introduction This study aims to evaluate the primary anatomical success and visual outcomes of 25-gauge pars plana vitrectomy (25g PPV) in patients with rhegmatogenous retinal detachment (RRD) in Pakistan. Design This is a five-year retrospective, interventional cohort study conducted at tertiary care hospitals in Pakistan from October 2013 to October 2018. Methods This is a retrospective, interventional cohort study of 418 consecutive patients with RRD who underwent 25g PPV. All surgeries were performed by two experienced surgeons at tertiary care hospitals in Pakistan. Consecutive patients who underwent 25g PPV surgery as the treatment for RRD from October 2013 to October 2018 were included. We excluded patients who had a history of previous retinal surgery or did not complete the 4-8 weeks of primary outcome visit. We used the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM Corporation, Armonk, NY, USA) for statistical analysis. A p-value of <0.05 was considered significant. Results We identified 452 patients through the coding system of our hospitals who underwent 25g PPV surgery for RRD during the study period. A total of 441 patient files were reviewed for the study, of which 418 patients met the criteria for final analysis. The mean age was 49 ± 15.8 years. There was a higher number of males (n = 284, 67.9%). In our study, 186 (44.4%) patients were phakic at the time of presentation. The macula was detached in 361 (86.4%) patients. At the primary outcome visit (4-8 weeks of follow-up), the primary anatomical success rate was 89.47%. The most common cause of failure was proliferative vitreoretinopathy (PVR) (n = 20), followed by missed breaks (n = 5). Conclusions The surgical outcomes of RRD with 25g PPV surgery in our study were similar to the outcomes reported in the developed world. We propose a prospective multicenter national study to prospectively evaluate the risk factors for RRD surgical failure in the Pakistani population.
摘要：
简介本研究旨在评估巴基斯坦流源性视网膜脱离（RRD）患者的25号平面玻璃体切除术（25gPPV）的主要解剖学成功和视觉效果。设计这是一个为期五年的回顾展，2013年10月至2018年10月在巴基斯坦三级医院进行的介入队列研究。方法这是一项回顾性研究,对418例接受25gPPV的RRD患者进行干预队列研究。所有手术均由巴基斯坦三级医院的两名经验丰富的外科医生进行。纳入2013年10月至2018年10月连续接受25gPPV手术治疗RRD的患者。我们排除了既往有视网膜手术史或未完成4-8周主要结局访视的患者。我们使用了社会科学统计软件包(SPSS)23.0版(IBM公司，Armonk,NY,美国)用于统计分析。<0.05的p值被认为是显著的。结果我们通过医院的编码系统确定了452例患者，在研究期间接受了25gPPV手术的RRD。该研究共审查了441份患者档案，其中418例患者符合最终分析标准。平均年龄为49±15.8岁。男性人数较多（n=284，占67.9％）。在我们的研究中,186例（44.4%）患者在就诊时出现了有晶状体。361例(86.4%)患者黄斑脱落。在主要结果访视（随访4-8周）时，主要解剖成功率为89.47%。最常见的失败原因是增生性玻璃体视网膜病变（PVR）（n=20），其次是错过的休息（n=5）。结论在我们的研究中，RRD与25gPPV手术的手术结果与发达国家报道的结果相似。我们提出了一项前瞻性多中心国家研究，以前瞻性评估巴基斯坦人群RRD手术失败的危险因素。
