Bradley T Smith, M Zia Siddiqui, Gautam Vangipuram, Charles Li, Xuan Peng, Flora Lum
{"title":"玻璃体切除术后气动视网膜固定术的发生率和理由。","authors":"Bradley T Smith, M Zia Siddiqui, Gautam Vangipuram, Charles Li, Xuan Peng, Flora Lum","doi":"10.1016/j.oret.2025.05.007","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To report the rate and rationale for vitrectomy (PPV) following retinal detachment (RD) repair with pneumatic retinopexy (PnR).</p><p><strong>Design: </strong>Retrospective, nonrandomized, comparative study.</p><p><strong>Participants: </strong>IRIS® Registry (Intelligent Research in Sight) patients undergoing PnR from 04/01/2013 to 12/31/2021.</p><p><strong>Methods: </strong>Billing codes were used to apply inclusion/exclusion and define three groups for comparison following PnR. Group 1 eyes had a non-RD PPV following PnR. Group 2 did not require a surgical procedure following PnR. Group 3 had RD that required surgical repair following PnR.</p><p><strong>Main outcome measures: </strong>Subsequent PPV for indications other than RD repair, follow-up duration and visual acuity (VA).</p><p><strong>Results: </strong>9,488 eyes of 9,401 patients met the study criteria. Mean age was 65 and most were males (60.2%). 9,107 of these eyes were analyzed according to the inclusion/exclusion criteria. Group 1 included 556 eyes, Group 2 included 5,351, and Group 3 included 3,200. In Group 1, PPV alone was performed in 30.8% (171 eyes), internal limiting membrane was removed in 25.7% (143 eyes), and epiretinal membrane was removed in 18.3% (102 eyes). Panretinal or focal endolaser photocoagulation was performed with a PPV in 13.3% (74 eyes) and 11.9% (66 eyes), respectively. Average baseline VA in Group 1 (0.35 logMAR, 20/45) was similar to Group 2 (0.33 logMAR, 20/43). Mean final VA was lower (0.33 logMAR (20/43) versus 0.21 logMAR (20/32), p<0.001), mean follow-up duration was longer (1,556 days versus 1,227, p<0.001), and more were male (63.3% versus 56.1%, p=0.006). Mean follow-up duration was longer than Group 3 (1,401 days, p=0.002) while final VA was similar to Group 3 (0.38 logMAR (20/48), p=0.50). 64.9% (5,907 eyes) were reattached using PnR and 9.4% (556) of these required a non-RD PPV.</p><p><strong>Conclusions: </strong>Nearly one in 10 eyes required a non-RD PPV following reattachment with PnR. VA outcomes were similar to eyes requiring surgical repair for RD. The possible need for PPV after reattachment with PnR should be addressed when counseling patients.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. 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Group 1 eyes had a non-RD PPV following PnR. Group 2 did not require a surgical procedure following PnR. Group 3 had RD that required surgical repair following PnR.</p><p><strong>Main outcome measures: </strong>Subsequent PPV for indications other than RD repair, follow-up duration and visual acuity (VA).</p><p><strong>Results: </strong>9,488 eyes of 9,401 patients met the study criteria. Mean age was 65 and most were males (60.2%). 9,107 of these eyes were analyzed according to the inclusion/exclusion criteria. Group 1 included 556 eyes, Group 2 included 5,351, and Group 3 included 3,200. In Group 1, PPV alone was performed in 30.8% (171 eyes), internal limiting membrane was removed in 25.7% (143 eyes), and epiretinal membrane was removed in 18.3% (102 eyes). Panretinal or focal endolaser photocoagulation was performed with a PPV in 13.3% (74 eyes) and 11.9% (66 eyes), respectively. Average baseline VA in Group 1 (0.35 logMAR, 20/45) was similar to Group 2 (0.33 logMAR, 20/43). Mean final VA was lower (0.33 logMAR (20/43) versus 0.21 logMAR (20/32), p<0.001), mean follow-up duration was longer (1,556 days versus 1,227, p<0.001), and more were male (63.3% versus 56.1%, p=0.006). Mean follow-up duration was longer than Group 3 (1,401 days, p=0.002) while final VA was similar to Group 3 (0.38 logMAR (20/48), p=0.50). 64.9% (5,907 eyes) were reattached using PnR and 9.4% (556) of these required a non-RD PPV.</p><p><strong>Conclusions: </strong>Nearly one in 10 eyes required a non-RD PPV following reattachment with PnR. VA outcomes were similar to eyes requiring surgical repair for RD. The possible need for PPV after reattachment with PnR should be addressed when counseling patients.</p>\",\"PeriodicalId\":19501,\"journal\":{\"name\":\"Ophthalmology. 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引用次数: 0
摘要
目的：报道玻璃体切除术（PPV）后视网膜脱离（RD）气动视网膜固定术（PnR）的发生率和基本原理。设计：回顾性、非随机、比较研究。参与者：2013年4月1日至2021年12月31日期间接受PnR的IRIS®注册（Intelligent Research in Sight）患者。方法：采用计费代码进行纳入/排除，并定义三组进行PnR后的比较。组1眼在PnR后出现非rd性PPV。第二组在PnR后不需要手术。第3组有RD，在PnR后需要手术修复。主要结局指标：除RD修复外的其他适应症的PPV，随访时间和视力（VA）。结果：9401例患者中9488只眼符合研究标准。平均年龄65岁，男性居多（60.2%）。根据纳入/排除标准对9107只眼睛进行分析。1组556只眼，2组5351只眼，3组3200只眼。1组仅行PPV手术者占30.8%（171眼），切除内限制膜者占25.7%（143眼），切除视网膜前膜者占18.3%（102眼）。采用PPV进行全视网膜或局部激光光凝治疗的患者分别为13.3%（74眼）和11.9%（66眼）。组1的平均基线VA （0.35 logMAR, 20/45）与组2相似（0.33 logMAR, 20/43）。平均最终VA较低（0.33 logMAR（20/43）和0.21 logMAR(20/32)）。结论：近十分之一的眼睛在再附着PnR后需要非rd PPV。VA的结果与RD需要手术修复的眼睛相似。在咨询患者时，应解决PnR再附着后PPV的可能需求。
Participants: IRIS® Registry (Intelligent Research in Sight) patients undergoing PnR from 04/01/2013 to 12/31/2021.
Methods: Billing codes were used to apply inclusion/exclusion and define three groups for comparison following PnR. Group 1 eyes had a non-RD PPV following PnR. Group 2 did not require a surgical procedure following PnR. Group 3 had RD that required surgical repair following PnR.
Main outcome measures: Subsequent PPV for indications other than RD repair, follow-up duration and visual acuity (VA).
Results: 9,488 eyes of 9,401 patients met the study criteria. Mean age was 65 and most were males (60.2%). 9,107 of these eyes were analyzed according to the inclusion/exclusion criteria. Group 1 included 556 eyes, Group 2 included 5,351, and Group 3 included 3,200. In Group 1, PPV alone was performed in 30.8% (171 eyes), internal limiting membrane was removed in 25.7% (143 eyes), and epiretinal membrane was removed in 18.3% (102 eyes). Panretinal or focal endolaser photocoagulation was performed with a PPV in 13.3% (74 eyes) and 11.9% (66 eyes), respectively. Average baseline VA in Group 1 (0.35 logMAR, 20/45) was similar to Group 2 (0.33 logMAR, 20/43). Mean final VA was lower (0.33 logMAR (20/43) versus 0.21 logMAR (20/32), p<0.001), mean follow-up duration was longer (1,556 days versus 1,227, p<0.001), and more were male (63.3% versus 56.1%, p=0.006). Mean follow-up duration was longer than Group 3 (1,401 days, p=0.002) while final VA was similar to Group 3 (0.38 logMAR (20/48), p=0.50). 64.9% (5,907 eyes) were reattached using PnR and 9.4% (556) of these required a non-RD PPV.
Conclusions: Nearly one in 10 eyes required a non-RD PPV following reattachment with PnR. VA outcomes were similar to eyes requiring surgical repair for RD. The possible need for PPV after reattachment with PnR should be addressed when counseling patients.
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