背景:本研究调查了与复发性孔源性视网膜脱离(RRD)相关的因素,黄斑并发症,在不使用全氟化碳液体(PPCL)的情况下进行原发性RRD的平坦部玻璃体切除术(PPV)和视觉结果。
方法:一项纵向队列研究包括连续接受无PFCLPPV的RRD患者。术后视力和谱域光学相干断层扫描结果[囊样黄斑水肿(CME),视网膜前膜(ERM),收集椭球区/叉指区(EZ/IZ)损伤]。Logistic回归和线性混合模型分析了RRD复发率和危险因素。CME,ERM,EZ/IZ伤害,和12个月时的视力。
结果:研究了346只RRD眼。单纯性(n=274只眼)和复杂性(n=72只眼)RRD的单次手术成功率分别为96%和93%。分别。与RRD复发相关的因素是后部视网膜破裂[与周边视网膜破裂相比,比值比(OR)=10.7,p=0.008],硅油填塞(与气体相比,OR=5.66,p=0.01),和扇形激光视网膜固定术(与360°激光视网膜固定术相比,OR=4.34,p=0.007)。CME的患病率,ERM,12个月时的EZ/IZ伤害为10%,9%,6%,分别。在简单和复杂的RRD中,EZ/IZ缺陷的眼睛术后视力较差。增生性玻璃体视网膜病变(OR=2.95,p=0.03)和硅油填塞(与气体相比,OR=3.70,p=0.05)与EZ/IZ损伤有关。
结论:无PFCL的PPV在简单和复杂的RRD中表现出令人满意的单次手术成功率,黄斑并发症的患病率较低。分析与RRD复发相关的因素可以为没有随机试验的无PFCL方法提供临时建议。
BACKGROUND: This study investigates factors associated with recurrent rhegmatogenous retinal detachment (RRD), macular complications, and visual outcomes after pars plana vitrectomy (PPV) without perfluorocarbon liquids (PFCLs) for primary RRD.
METHODS: A longitudinal cohort study included consecutive patients with RRD who underwent PFCL-free PPV. Postoperative visual acuity and spectral-domain optical coherence tomography findings [cystoid macular edema (CME), epiretinal membrane (ERM), ellipsoid zone/interdigitation zone (EZ/IZ) damage] were collected. Logistic regression and linear mixed models analyzed rates and risk factors for RRD recurrence, CME, ERM, EZ/IZ damage, and visual acuity at 12 months.
RESULTS: 346 eyes with RRD were studied. Single-operation success rates were 96% and 93% for uncomplicated (n = 274 eyes) and complicated (n = 72 eyes) RRD, respectively. Factors associated with RRD recurrence were posterior retinal breaks [odds ratio (OR) = 10.7 compared to peripheral retinal breaks, p = 0.008], silicone oil tamponade (OR = 5.66 compared to gas, p = 0.01), and sectorial laser retinopexy (OR = 4.34 compared to 360° laser retinopexy, p = 0.007). The prevalence of CME, ERM, and EZ/IZ damage at 12 months was 10%, 9%, and 6%, respectively. Eyes with EZ/IZ defects had worse postoperative visual acuity in both uncomplicated and complicated RRD. Proliferative vitreoretinopathy (OR = 2.95, p = 0.03) and silicone oil tamponade (OR = 3.70 compared to gas, p = 0.05) were associated with EZ/IZ damage.
CONCLUSIONS: PFCL-free PPV demonstrated satisfactory single-operation success rates for uncomplicated and complicated RRD, with a low prevalence of macular complications. Analyzing factors associated with RRD recurrence can provide provisional recommendations for PFCL-free approaches in the absence of randomized trials.