Postoperative complications after successful primary rhegmatogenous retinal detachment repair

BMC Ophthalmology

Research Article

Alessandro Meduri¹  Rino Frisina²  Lorenzo Motta³  Gabriella De Salvo⁴  Angelo Greggio⁵  Irene Gius⁵  Matteo Ripa⁶  Luigi Tozzi⁷ 

[1] Department of Biomedical Sciences, Eye Clinic, University of Messina, Messina, Italy;Department of Guglielmo da Saliceto Hospital, Ophthalmology Unit of Surgery, Piacenza, Italy;Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford, UK;Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK;Ophthalmology Department, University of Padova, Padova, Italy;Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy;Catholic University “Sacro Cuore”, Rome, Italy;Ophthalmology department, San Martino Hospital, Belluno, Italy;

关键词: Cystoid macular edema;    Epiretinal membrane;    Internal limiting membrane;    Pars plana vitrectomy;    Rhegmatogenous retinal detachment;    Scleral buckling;   

DOI  :  10.1186/s12886-023-02824-5

 received in 2022-09-11, accepted in 2023-02-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTo evaluate the incidence and risk factors for cystoid macular edema (CME) and epiretinal membrane (ERM) development after surgery for primary rhegmatogenous retinal detachment (RRD).MethodsRetrospective observational cohort study involving 62 consecutive patients with primary RRD who underwent RRD repair with either scleral buckling (SB) or pars plana vitrectomy (PPV). SB was used in young phakic patients without posterior vitreous detachment (PVD), high myopic patients, and RRD associated with either anterior or inferior retinal tears. PPV was preferred over SB in pseudophakic patients or those with media opacity and posterior breaks that precluded the SB approach. After surgery, the macular changes, including CME and ERM development, were evaluated 3 and 6 months postoperatively. Phacoemulsification and intraocular lens (IOL) implantation were performed in phakic patients where media opacity or lens bulging did not allow the surgeon to perform surgical maneuvers. The inner limiting membrane (ILM) peeling was randomly performed in the macula-off and the macula-on RRD “pending foveal detachment” subgroup.ResultsSixty-two eyes affected by RRD who underwent SB or PPV were enrolled. CME occurred in 33.3% of the PPV group regardless of the ERM formation. No CME cases were found in the SB group. Macula-off RRD increased the risk of CME by odds ratio (OR) = 4.3 times compared to macula-on RRD regardless of the surgical procedure (p = 0.04). Macula-off status increased the risk of CME of OR = 1.73 times compared to macula-on in the PPV subgroup (p = 0.4). Combined cataract surgery and PPV increased the risk of CME by OR = 3.3 times (p = 0.16) compared to PPV alone, and ILM peeling increased the risk of postoperative CME by OR = 1.8 times (p = 0.37). ERM occurred in 28% of patients who did not undergo ILM peeling, and 29.42% of those who underwent ILM peeling developed ERM (p = 0.6).ConclusionsThe risk of postoperative CME was higher in patients with macula-off than in macula-on RRD and in those with macula-off RRD who underwent PPV. The SB would be advisable in patients with RRD sparing the macula. Furthermore, despite having several advantages, the combined phacoemulsification plus IOL implantation and PPV highly increased the risk of postoperative CME.

【 授权许可】

CC BY   
© The Author(s) 2023

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