Amine Habib, Nour Boungab, Karine Lagrené, Maxime Wack, Sarah Ayello-Scheer, Francine Behar-Cohen, Pierre-Olivier Barale, Stéphane Bertin, Aliénor Vienne-Jumeau
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引用次数: 0
Abstract
Purpose: To evaluate associations between retinopexy modality, surgical and anatomical factors, and single-surgery anatomical success (SSAS) after pars plana vitrectomy (PPV) for primary inferior rhegmatogenous retinal detachment (RRD).
Methods: This retrospective single-center cohort included consecutive eyes undergoing PPV for primary inferior RRD with at least 3 months of follow-up. The primary outcome was SSAS, defined as absence of redetachment during follow-up and at least 2 months after silicone oil removal when applicable.
Results: Among 235 eyes, median follow-up was 8 months. SSAS was achieved in 175 eyes (74.5%), while 60 eyes (25.5%) redetached at a median of 35 days. SSAS was 83.3% with endolaser, 74.6% with combined retinopexy, and 64.6% with cryotherapy (p = 0.021). In multivariable analysis, endolaser was associated with lower odds of failure compared with cryotherapy (OR 0.21, 95% CI 0.09-0.48; p = 0.00037), while combined retinopexy was associated with intermediate odds of failure (OR 0.39, 95% CI 0.15-0.95; p = 0.043). Compared with PVR grade A, grade B (OR 5.19, 95% CI 2.30-12.37; p = 0.00011) and grade C (OR 10.60, 95% CI 4.15-28.84; p < 0.00001) were associated with higher odds of anatomical failure. A causative break at 6 o'clock was also associated with higher odds of failure (OR 4.61; p = 0.005).
Conclusion: In PPV for inferior RRD, endolaser retinopexy was associated with significantly higher anatomical success than cryotherapy, with combined treatment yielding intermediate outcomes. No significant association was observed between anatomical outcome and tamponade choice or PFCL use.
目的：评价玻璃体切割（PPV）治疗原发性下孔源性视网膜脱离（RRD）后视网膜固定方式、手术和解剖因素与单次手术解剖成功率（SSAS）的关系。方法：该回顾性单中心队列包括连续的眼睛接受PPV治疗原发性下缘RRD，随访至少3个月。主要结果是SSAS，定义为随访期间无再脱离，并且在硅油去除后至少2个月（如果适用）。结果：235只眼中位随访时间为8个月。175只眼（74.5%）获得SSAS， 60只眼（25.5%）在中位35天内再次脱离。激光组的SSAS为83.3%，联合视网膜固定术组为74.6%，冷冻治疗组为64.6% （p = 0.021）。在多变量分析中，与冷冻治疗相比，内激光治疗与较低的失败几率相关（OR 0.21, 95% CI 0.09-0.48; p = 0.00037），而联合视网膜固定与中等失败几率相关（OR 0.39, 95% CI 0.15-0.95; p = 0.043）。与PVR A级相比，B级（OR 5.19, 95% CI 2.30-12.37; p = 0.00011）和C级（OR 10.60, 95% CI 4.15-28.84; p < 0.00001）解剖失败的几率更高。6点钟的致病断裂也与较高的失败几率相关（OR 4.61; p = 0.005）。结论：在治疗下段RRD的PPV中，内激光视网膜固定术的解剖成功率明显高于冷冻治疗，联合治疗效果中等。解剖结果与填塞选择或PFCL的使用之间没有明显的关联。
期刊介绍：
RETINA® focuses exclusively on the growing specialty of vitreoretinal disorders. The Journal provides current information on diagnostic and therapeutic techniques. Its highly specialized and informative, peer-reviewed articles are easily applicable to clinical practice.
In addition to regular reports from clinical and basic science investigators, RETINA® publishes special features including periodic review articles on pertinent topics, special articles dealing with surgical and other therapeutic techniques, and abstract cards. Issues are abundantly illustrated in vivid full color.
Published 12 times per year, RETINA® is truly a “must have” publication for anyone connected to this field.
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