Risk of rhegmatogenous retinal detachment following pars plana vitrectomy for full-thickness macular hole and epiretinal membrane in pseudophakic eyes.

IF 2.8 3区医学 Q1 OPHTHALMOLOGY

Acta Ophthalmologica Pub Date : 2025-08-15 DOI:10.1111/aos.17579

Birgitte Romme Nielsen, Morten la Cour, Mark Alberti, Ulrik Christensen, Thomas Scheike, Jakob Grauslund, Lonny Stokholm

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Abstract

Purpose: To estimate the risk of rhegmatogenous retinal detachment (RRD) following pars plana vitrectomy (PPV) for full-thickness macular hole (FTMH) or epiretinal membrane (ERM) in pseudophakic eyes.

Methods: We conducted a nationwide Danish registry-based cohort study from 2010 to 2023. Eyes entered the study at phacoemulsification surgery (age ≥ 50) and were followed until outcome (RRD), exposure (PPV), or censoring (death, end of study, or competing events). PPV was analysed as a time-dependent exposure occurring after phacoemulsification surgery, with eyes considered exposed from the time of PPV onwards.

Results: A total of 680 858 eyes were included. Median follow-up was 4.8 years (IQR, 2.5-7.9) after phacoemulsification and 5.0 years (2.5-7.9) after PPV, with a median interval of 76 days (39-328) between procedures. The 1-year cumulative incidence of RRD after PPV for FTMH was 0.62% (95% CI, 0.40-0.93), significantly higher in males. For ERM, it was 0.43% (0.27-0.66), with no sex difference. Compared to phacoemulsification alone, the hazard ratio (HR) for RRD was increased in males operated on for FTMH (HR 2.60; 1.62-4.17) and in females operated on for ERM (HR 1.93; 1.07-3.49). Among those who remained event-free 1 year postoperatively, no significant difference in RRD risk was observed between groups.

Conclusions: PPV in pseudophakic eyes has a low risk of RRD but higher than that of phacoemulsification surgery after the first year, with notable sex variations for FTMH. Among those who remained event-free 1 year postoperative, no difference in RRD risk was observed between PPV and phacoemulsification surgery.

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假晶状眼全层黄斑孔及视网膜前膜玻璃体切除术后孔源性视网膜脱离的风险。

目的：评价假晶状眼全层黄斑孔（FTMH）或视网膜前膜（ERM）玻璃体切除术（PPV）术后孔源性视网膜脱离（RRD）的风险。方法：我们在2010年至2023年进行了一项丹麦全国范围内基于登记的队列研究。眼睛在超声乳化手术时进入研究（年龄≥50岁），并随访至结果（RRD）、暴露（PPV）或审查（死亡、研究结束或竞争事件）。PPV被分析为超声乳化手术后发生的时间依赖性暴露，眼睛从PPV时间开始被认为暴露。结果：共纳入680858只眼。超声乳化术后的中位随访时间为4.8年（IQR, 2.5-7.9）， PPV术后的中位随访时间为5.0年（2.5-7.9），两次手术之间的中位随访时间间隔为76天（39-328）。FTMH PPV后1年累计RRD发生率为0.62% (95% CI, 0.40-0.93)，男性显著高于男性。ERM为0.43%(0.27 ~ 0.66)，无性别差异。与单纯超声乳化术相比，男性FTMH手术中RRD的风险比（HR）增加(HR 2.60；1.62-4.17)，女性为ERM手术(HR 1.93；1.07 - -3.49)。在术后1年无事件发生的患者中，两组间RRD风险无显著差异。结论：假晶状眼PPV术后1年发生RRD的风险较低，但高于超声乳化手术，且FTMH的性别差异显著。在术后1年无事件发生的患者中，PPV和超声乳化手术在RRD风险方面没有差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.