Recurrences and Macular Complications after Perfluorocarbon-Liquid-Free Vitrectomy for Primary Rhegmatogenous Retinal Detachment,Ophthalmology and Therapy

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Recurrences and Macular Complications after Perfluorocarbon-Liquid-Free Vitrectomy for Primary Rhegmatogenous Retinal Detachment
Ophthalmology and Therapy ( IF 2.6 ) Pub Date : 2023-09-29 , DOI: 10.1007/s40123-023-00811-z
Maria Vittoria Cicinelli _{1,

2,

3} , Eleonora Benatti ₁ , Vincenzo Starace ₁ , Francesco Nadin _{1,

2,

3} , Edoardo Di Nisi ₂ , Francesco Bandello _{2,

3} , Michele Coppola _{1,

2}

Affiliation

Introduction

This study investigates factors associated with recurrent rhegmatogenous retinal detachment (RRD), macular complications, and visual outcomes after pars plana vitrectomy (PPV) without perfluorocarbon liquids (PFCLs) for primary RRD.

Methods

A longitudinal cohort study included consecutive patients with RRD who underwent PFCL-free PPV. Postoperative visual acuity and spectral-domain optical coherence tomography findings [cystoid macular edema (CME), epiretinal membrane (ERM), ellipsoid zone/interdigitation zone (EZ/IZ) damage] were collected. Logistic regression and linear mixed models analyzed rates and risk factors for RRD recurrence, CME, ERM, EZ/IZ damage, and visual acuity at 12 months.

Results

346 eyes with RRD were studied. Single-operation success rates were 96% and 93% for uncomplicated (n = 274 eyes) and complicated (n = 72 eyes) RRD, respectively. Factors associated with RRD recurrence were posterior retinal breaks [odds ratio (OR) = 10.7 compared to peripheral retinal breaks, p = 0.008], silicone oil tamponade (OR = 5.66 compared to gas, p = 0.01), and sectorial laser retinopexy (OR = 4.34 compared to 360° laser retinopexy, p = 0.007). The prevalence of CME, ERM, and EZ/IZ damage at 12 months was 10%, 9%, and 6%, respectively. Eyes with EZ/IZ defects had worse postoperative visual acuity in both uncomplicated and complicated RRD. Proliferative vitreoretinopathy (OR = 2.95, p = 0.03) and silicone oil tamponade (OR = 3.70 compared to gas, p = 0.05) were associated with EZ/IZ damage.

Conclusions

PFCL-free PPV demonstrated satisfactory single-operation success rates for uncomplicated and complicated RRD, with a low prevalence of macular complications. Analyzing factors associated with RRD recurrence can provide provisional recommendations for PFCL-free approaches in the absence of randomized trials.

中文翻译：

全氟化碳无液玻璃体切除术治疗原发性孔源性视网膜脱离后的复发和黄斑并发症

介绍

本研究调查了与复发性孔源性视网膜脱离 (RRD)、黄斑并发症以及原发性 RRD 不使用全氟化碳液体 (PFCL) 的玻璃体切除术 (PPV) 后的视力结果相关的因素。

方法

一项纵向队列研究包括接受无 PFCL PPV 的连续 RRD 患者。收集术后视力和谱域光学相干断层扫描结果[黄斑囊样水肿（CME）、视网膜前膜（ERM）、椭圆体区/指叉区（EZ/IZ）损伤]。 Logistic 回归和线性混合模型分析了 12 个月时 RRD 复发、CME、ERM、EZ/IZ 损伤和视力的发生率和危险因素。

结果

对 346 只患有 RRD 的眼睛进行了研究。对于简单性（ n = 274 只眼）和复杂性（ n = 72 只眼）RRD，单次手术成功率分别为 96% 和 93%。与 RRD 复发相关的因素包括后部视网膜裂孔[与周边视网膜裂孔相比，比值比 (OR) = 10.7， p = 0.008]、硅油填充（与气体相比，OR = 5.66， p = 0.01）和扇形激光视网膜固定术（OR） = 4.34 与 360° 激光视网膜固定术相比， p = 0.007）。 12 个月时 CME、ERM 和 EZ/IZ 损伤的发生率分别为 10%、9% 和 6%。在单纯性和复杂性 RRD 中，存在 EZ/IZ 缺陷的眼睛术后视力均较差。增殖性玻璃体视网膜病变（OR = 2.95， p = 0.03）和硅油填充（与气体相比，OR = 3.70， p = 0.05）与 EZ/IZ 损伤相关。