Abstract：
BACKGROUND: This study aimed to investigate the incidence of and risk factors for epiretinal membrane (ERM) formation following primary rhegmatogenous retinal detachment (RRD) repair.
METHODS: This comparative, retrospective, single-center cohort study included eyes with primary RRD treated between 2011 and 2023 at Massachusetts Eye and Ear, Boston, Massachusetts, with pars plana vitrectomy (PPV), scleral buckle (SB), PPV+SB, or pneumatic retinopexy (PnR). Demographic, clinical, and surgical parameters were collected from medical records. The primary outcome was the risk of ERM formation, while the secondary outcome was the risk of ERM requiring surgery. Univariable and multivariable Cox regression were performed, and a hazard ratio (HR) and 95% confidence interval (95% CI) were reported.
RESULTS: Overall, 394 eyes were included. The mean age was 58.49 ± 12.8 years, and most patients were male. There was a significantly lower risk of ERM formation following SB compared to PPV in the univariable analysis (HR = 0.2, 95% CI = 0.08-0.60, p = 0.003); however, there was no significant association between treatment modality and ERM formation on multivariable Cox regression controlling for confounding factors (p = 0.24). ERM formation was found more commonly in patients who were older (HR = 1.0 per 1 year increase in age, 95% CI = 1.01-1.04, p = 0.001), those with worse baseline visual acuity (HR = 1.3, 95% CI = 1.09-1.71, p = 0.008), and those with macula-off RRDs (HR = 2.1, 95% CI = 1.41-3.32, p < 0.001).
CONCLUSIONS: Surgical modality does not have a significant impact on the risk of ERM following retinal detachment repair. However, age, baseline visual acuity, and macular status are important predictors of ERM formation after RRD repair.
METHODS: This comparative, retrospective, single-center cohort study included eyes with primary RRD treated between 2011 and 2023 at Massachusetts Eye and Ear, Boston, Massachusetts, with pars plana vitrectomy (PPV), scleral buckle (SB), PPV+SB, or pneumatic retinopexy (PnR). Demographic, clinical, and surgical parameters were collected from medical records. The primary outcome was the risk of ERM formation, while the secondary outcome was the risk of ERM requiring surgery. Univariable and multivariable Cox regression were performed, and a hazard ratio (HR) and 95% confidence interval (95% CI) were reported.
RESULTS: Overall, 394 eyes were included. The mean age was 58.49 ± 12.8 years, and most patients were male. There was a significantly lower risk of ERM formation following SB compared to PPV in the univariable analysis (HR = 0.2, 95% CI = 0.08-0.60, p = 0.003); however, there was no significant association between treatment modality and ERM formation on multivariable Cox regression controlling for confounding factors (p = 0.24). ERM formation was found more commonly in patients who were older (HR = 1.0 per 1 year increase in age, 95% CI = 1.01-1.04, p = 0.001), those with worse baseline visual acuity (HR = 1.3, 95% CI = 1.09-1.71, p = 0.008), and those with macula-off RRDs (HR = 2.1, 95% CI = 1.41-3.32, p < 0.001).
CONCLUSIONS: Surgical modality does not have a significant impact on the risk of ERM following retinal detachment repair. However, age, baseline visual acuity, and macular status are important predictors of ERM formation after RRD repair.
摘要：
背景：本研究旨在探讨原发性孔源性视网膜脱离（RRD）修复后视网膜前膜（ERM）形成的发生率和危险因素。
方法：这个比较，回顾性,单中心队列研究包括2011年至2023年在马萨诸塞州眼和耳治疗的原发性RRD眼，波士顿,马萨诸塞州,进行平坦部玻璃体切除术（PPV），巩膜带扣(SB),PPV+SB,或气动视网膜固定术（PnR）。人口统计,临床,和手术参数从医疗记录中收集。主要结果是ERM形成的风险，而次要结局是需要手术治疗的ERM风险.进行单变量和多变量Cox回归，报告了风险比（HR）和95％置信区间（95CI）。
结果：总体而言，包括394只眼。平均年龄为58.49±12.8岁，大多数患者为男性。在单变量分析中，与PPV相比，SB后ERM形成的风险显着降低(HR=0.22，95CI=0.08-0.60，p=0.003)；然而，多变量Cox回归控制混杂因素后,治疗方式与ERM形成之间无显著关联(p=0.24).ERM形成在年龄较大的患者中更常见（HR=1.03每1岁增加，95CI=1.01-1.04，p=0.001），基线视力较差的患者（HR=1.36，95CI=1.09-1.71，p=0.008），和黄斑脱落的RRD（HR=2.16，95CI=1.41-3.32，p<0.001）。
结论：手术方式对视网膜脱离修复后的ERM风险没有显著影响。然而,年龄,基线视力，黄斑状态是RRD修复后ERM形成的重要预测因子。
方法：这个比较，回顾性,单中心队列研究包括2011年至2023年在马萨诸塞州眼和耳治疗的原发性RRD眼，波士顿,马萨诸塞州,进行平坦部玻璃体切除术（PPV），巩膜带扣(SB),PPV+SB,或气动视网膜固定术（PnR）。人口统计,临床,和手术参数从医疗记录中收集。主要结果是ERM形成的风险，而次要结局是需要手术治疗的ERM风险.进行单变量和多变量Cox回归，报告了风险比（HR）和95％置信区间（95CI）。
结果：总体而言，包括394只眼。平均年龄为58.49±12.8岁，大多数患者为男性。在单变量分析中，与PPV相比，SB后ERM形成的风险显着降低(HR=0.22，95CI=0.08-0.60，p=0.003)；然而，多变量Cox回归控制混杂因素后,治疗方式与ERM形成之间无显著关联(p=0.24).ERM形成在年龄较大的患者中更常见（HR=1.03每1岁增加，95CI=1.01-1.04，p=0.001），基线视力较差的患者（HR=1.36，95CI=1.09-1.71，p=0.008），和黄斑脱落的RRD（HR=2.16，95CI=1.41-3.32，p<0.001）。
结论：手术方式对视网膜脱离修复后的ERM风险没有显著影响。然而,年龄,基线视力，黄斑状态是RRD修复后ERM形成的重要预测因子。
