孔源性视网膜脱离(RRD)修复后的视网膜移位是评估再附着完整性的重要考虑因素。对功能结果有潜在影响。比较各种手术技术的数据有限。我们对RRD修复后的视网膜位移进行了回顾,直到2021年10月,发现21项研究涵盖了1,258只独特的眼睛。结果测量包括视网膜移位的频率,视敏度,变态,和位移方向。使用报告为风险比(RR)或平均差和95%置信区间的数据进行荟萃分析。在35±20%的RRD修复中发现视网膜移位。没有填塞的巩膜扣(SB)的视网膜移位率最低,然后是气动视网膜固定术(PnR),最后是平坦部玻璃体切除术(PPV)(PPV的RR与SB:9.60[2.01-45.95],P=0.005)。与气体相比,硅油可降低PPV后的置换风险(气体中的RR与SO:2.16[1.22-3.83],P=0.009),可以立即面朝下定位2小时。在92±14%的病例中,PPV后的视网膜移位发生在向下方向,并且似乎没有显着影响视力(0.05[-0.21至0.31],P=0.70),虽然它可能会增加失真。SB,PnR,含硅油的PPV,和立即面朝下定位可能与较少的视网膜位移有关。需要额外的前瞻性研究来增加这些发现的确定性。
Retinal displacement following rhegmatogenous retinal detachment (RRD) repair is an important consideration when assessing the integrity of reattachment, with potential implications on functional outcomes. There are limited data comparing various surgical techniques. We conducted a review of retinal displacement following RRD repair through October 2021, finding 21 studies encompassing 1,258 unique eyes. Outcome measures included the frequency of retinal displacement, visual acuity, metamorphopsia, and displacement direction. A meta-analysis was performed with data reported as risk ratios (RR) or mean difference and 95% confidence intervals. Retinal displacement was found in 35 ± 20% of RRD repairs. Scleral buckle (SB) without tamponade had the lowest rate of retinal displacement, followed by pneumatic retinopexy (PnR) and finally pars plana vitrectomy (PPV) (RR in PPV vs SB: 9.60 [2.01-45.95], P = 0.005). Silicone oil may reduce risk of displacement following PPV compared to gas (RR in gas vs SO: 2.16 [1.22-3.83], P = 0.009), as may immediate face-down positioning for 2 hours. Retinal displacement following PPV occurred in the downward direction in 92 ± 14% of cases and does not appear to significantly impact visual acuity (0.05 [-0.21 to 0.31], P = 0.70), although it may increase distortion. SB, PnR, PPV with silicone oil, and immediate face-down positioning are likely associated with less retinal displacement. Additional prospective studies are required to increase the certainty of these findings.