Risk factors for retinal breaks following surgical induction of posterior vitreous detachment: A scoping review.

IF 5.9 2区 医学 Q1 OPHTHALMOLOGY
Jai Ethan Paris, Carmelo Zak Macri, Stewart R Lake, Weng Onn Chan
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引用次数: 0

Abstract

Surgical induction of posterior vitreous detachment (IPVD) is a well-known risk factor for retinal breaks (RB) during vitrectomy; however, risk factors for breaks in the subgroup of eyes requiring IPVD are poorly characterised. We summarize and explore existing literature on demographic, clinical, and operative risk factors for RB in eyes that require IPVD. We conducted a comprehensive search of electronic databases (PubMed, Ovid MEDLINE, EMBASE, and Google Scholar) in August, 2024. We included English-language meta-analyses, randomised control trials, and observational studies or series that reported data addressing risk factors for retinal breaks during surgical IPVD. Case reports, conference abstracts, and pharmacological IPVD were excluded. A total of 10 studies were included, comprising observational studies (n = 4) and case series (n = 6). Risk factors identified in existing literature included age, surgical indication and gauge size. Younger age was associated with higher RB risk during IPVD (OR 0.959, 95 % CI 0.924, 0.996, p = 0.028). Surgical indication findings were conflicting, suggesting either macular hole or epiretinal membrane surgery may increase the rate of RB. Gauge size had no consistent impact on RB rates. Weak evidence exists that 20-G may increase RB rate compared to 23-G (23 G 3.1 % vs 20-G 15.8 %, p = 0.0234). The wide range in IPVD-related RB reflects highly heterogenous study designs, differences in IPVD induction technique, and failure to discriminate between IPVD-related and sclerotomy-related breaks. There remains no large-scale studies or meta-analyses exploring risk factors for RB during IPVD. Younger age is a risk factor for RB in IPVD. The impact of gauge size and surgical indication is conflicting in existing literature, and claims are supported by weak evidence. There is a lack of exploration of risk factors for RB during IPVD in existing literature. Further exploration of patient and operative risk factors is needed and may impact risk counselling and surgical approaches for eyes requiring IPVD.

手术诱导玻璃体后脱离后视网膜断裂的危险因素:范围回顾。
玻璃体手术诱导后玻璃体脱离(IPVD)是玻璃体切除术中视网膜断裂(RB)的一个众所周知的危险因素;然而,在需要IPVD的眼睛亚组中,骨折的危险因素特征不明显。我们总结和探讨了现有的关于需要IPVD的眼睛RB的人口统计学、临床和手术危险因素的文献。我们于2024年8月对PubMed、Ovid MEDLINE、EMBASE和谷歌Scholar等电子数据库进行了全面检索。我们纳入了英文荟萃分析、随机对照试验和观察性研究或系列研究,这些研究报告了手术诱导玻璃体后脱离(IPVD)过程中视网膜断裂的危险因素。排除病例报告、会议摘要和药理学IPVD。共纳入10项研究,包括观察性研究(n = 4)和病例系列(n = 6)。现有文献中确定的危险因素包括年龄、手术指征和量具尺寸。年龄越小,IPVD中RB风险越高(OR 0.959, 95% CI 0.924, 0.996, p=0.028)。手术指征结果相互矛盾,提示黄斑孔或视网膜前膜手术可能增加RB的发生率。轨距大小对RB率没有一致的影响,现有的证据是相互矛盾的。有微弱证据表明,与23G相比,20G可能会增加RB率(23G 3.1% vs 20G 15.8%, p=0.0234)。IPVD相关RB的广泛范围反映了研究设计的高度异质性,IPVD诱导技术的差异,以及未能区分IPVD相关和巩膜切开术相关的骨折。目前还没有大规模的研究或荟萃分析来探讨IPVD期间RB的危险因素。年轻是IPVD中发生RB的危险因素。在现有文献中,管径大小和手术指征的影响是相互矛盾的,而且这些说法的证据不足。在现有文献中,对IPVD期间RB的危险因素的探讨严重不足。需要进一步探索患者和手术的危险因素,这可能会影响需要IPVD的眼睛的风险咨询和手术方法。
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
Survey of ophthalmology
Survey of ophthalmology 医学-眼科学
CiteScore
10.30
自引率
2.00%
发文量
138
审稿时长
14.8 weeks
期刊介绍: Survey of Ophthalmology is a clinically oriented review journal designed to keep ophthalmologists up to date. Comprehensive major review articles, written by experts and stringently refereed, integrate the literature on subjects selected for their clinical importance. Survey also includes feature articles, section reviews, book reviews, and abstracts.
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