The cause of redetachment after vitrectomy with air tamponade for a cohort of 1715 patients with retinal detachment: an analysis of retinal breaks reopening.

IF 5.4 3区材料科学 Q2 CHEMISTRY, PHYSICAL ACS Applied Energy Materials Pub Date : 2023-02-03 DOI:10.1186/s40662-022-00325-y

Chuandi Zhou, Chufeng Gu, Bo Li, Yujie Wang, Yanan Hu, Xinping She, Ya Shi, Mingming Ma, Tao Sun, Qinghua Qiu, Ying Fan, Fenge Chen, Hong Wang, Kun Liu, Xiaodong Sun, Xun Xu, Zhi Zheng

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引用次数: 1

Abstract

Background: To investigate the prevalence and predictors of retinal breaks reopening after vitrectomy with air tamponade in rhegmatogenous retinal detachment (RRD).

Methods: A retrospective cohort study was conducted in Shanghai General Hospital. Chart review was performed among 1715 patients with primary RRD who received pars plana vitrectomy (PPV) with air tamponade as initial management. Patients were followed up for recurrence. The clinical features of the eyes with retinal breaks reopening were recorded. Logistic regression was constructed to investigate the predictors for breaks reopening.

Results: A total of 137 (7.99%) patients had recurrent retinal detachment after PPV with air tamponade. The causes of surgery failure included new or missed retinal breaks (48.9%), reopening of original tears (43.8%) and proliferative vitreoretinopathy (7.3%). The median time to recurrence for the patients with breaks reopening was 18.0 days. Multivariate logistic regression indicated that the presence of retinal break(s) ≥ 1.5 disc diameters (DD) (odds ratio [OR]: 2.68, 95% confidence interval [CI]: 11.04-6.92, P = 0.041), and shorter period for restricted activities (OR: 0.94, 95% CI: 0.89-0.99, P = 0.020) were the independent predictors for breaks reopening.

Conclusions: Breaks reopening is an important cause for retinal redetachment after PPV with air tamponade in primary RRD. The first 2-4 weeks after surgery is the "risk period" for breaks reopening. Special attention should be paid for patients with retinal break(s) ≥ 1.5 DD. A prolonged period for restricted activities is recommended.

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1715例视网膜脱离患者玻璃体切除空气填塞后再脱离的原因分析。

背景:探讨孔源性视网膜脱离(RRD)玻璃体切除术合并空气填塞后视网膜裂口重新开放的患病率及预测因素。方法:在上海总医院进行回顾性队列研究。对1715例原发性RRD患者进行了图表回顾，这些患者接受了玻璃体切割术(PPV)和空气填塞作为初始治疗。随访患者是否复发。记录视网膜裂孔再开的临床特征。采用Logistic回归分析对断口重开的预测因素进行分析。结果:有空气填塞的PPV术后复发性视网膜脱离137例(7.99%)。手术失败的原因包括新的或遗漏的视网膜破裂(48.9%)，原有泪液重新开放(43.8%)和增殖性玻璃体视网膜病变(7.3%)。切口再开的患者到复发的中位时间为18.0天。多因素logistic回归显示，视网膜破裂≥1.5椎间盘直径(DD)的存在(优势比[OR]: 2.68, 95%可信区间[CI]: 11.04-6.92, P = 0.041)和较短的受限活动时间(OR: 0.94, 95% CI: 0.89-0.99, P = 0.020)是裂口再开的独立预测因素。结论:裂口重新打开是原发性RRD合并空气填塞PPV术后视网膜再脱离的重要原因。手术后的头2-4周是骨折重新开放的“风险期”。应特别注意视网膜破裂≥1.5 DD的患者。建议延长限制活动的时间。

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来源期刊

ACS Applied Energy Materials Materials Science-Materials Chemistry

CiteScore

10.30

自引率

6.20%

发文量

1368

期刊介绍： ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.