孔源性视网膜脱离玻璃体切除术后继发黄斑前膜的危险因素分析

doi:10.6040/j.issn.1673-3770.0.2024.370

摘要/Abstract

摘要： 目的探讨影响孔源性视网膜脱离(rhegmatogenous retinal detachment, RRD)玻璃体切除手术后继发黄斑前膜的危险因素。方法选取因RRD行玻璃体切除手术患者109例(109眼),根据术后是否继发黄斑前膜分为继发黄斑前膜组12例(12眼)和非继发黄斑前膜组97例(97眼)。术后随访6个月,对比分析两组患者年龄、晶状体状态、视网膜裂孔情况、视网膜脱离是否累及黄斑区、PVR分级、是否玻璃体积血、术中填充物种类、激光数目指标,对黄斑前膜形成的影响因素行二元Logistic回归分析。结果 RRD玻璃体切除术后继发黄斑前膜发生率为11.01%。两组间晶状体状态、PVR分级比较差异均有统计学意义(χ2=11.608,P=0.001; χ2=14.492,P=0.001)。二元Logistic回归分析结果显示晶状体状态、PVR分级是术后继发性黄斑前膜的影响因素(OR=0.074,95%CI:0.008~0.670,P=0.021;OR=0.018,95%CI:0.001~0.503,P=0.018)。结论无晶体眼和人工晶体眼、PVR C级是术后继发黄斑前膜的危险因素。

关键词: 孔源性视网膜脱离, 玻璃体切除术, 继发性黄斑前膜, 危险因素

Abstract: Objective To analyze the influencing factors of epiretinal membrane formation after pars plana vitrectomy for primary rhegmatogenous retinal detachment(RRD). Methods A total of 109 patients(109 eyes)who underwent vitrectomy for rhegmatogenous retinal detachment(RRD)were included. Based on the postoperative occurrence of secondary epiretinal membrane(ERM), they were divided into two groups: the secondary ERM group(12 patients, 12 eyes)and the non-secondary ERM group(97 patients, 97 eyes). After 6 months of postoperative follow-up, the age, lens status, retinal hiatus, retinal detachment involved in macular area, PVR grade, vitreous hematoma, intraoperative fillings and laser number were compared between the two groups, and the influencing factors on the formation of macular anterior membrane were analyzed by binary Logistic regression. Results The incidence of epiretinal membrane after pars plana vitrectomy for RRD was 11.01%. There were statistically significant differences in the lens status and PVR grade between the two groups(χ2=11.608, P=0.001; χ2=14.492, P=0.001). The results of binary Logistic regression analysis showed that lens status and PVR C grade were influencing factors for postoperative epiretinal membrane(OR=0.074, 95%CI: 0.008~0.670, P=0.021; OR=0.018, 95%CI: 0.001~0.503, P=0.018). Conclusion Aphakic eye, intraocular lens eye, and PVR C grade were risk factors for postoperative epiretinal membrane.

Key words: Rhegmatogenous retinal detachment, Pars plana vitrectomy, Secondary epiretinal membrane, Risk factors

中图分类号:

R774.1+2

王焕霞,王淑雅,王影,孙璇,黄杰,王兴荣. 孔源性视网膜脱离玻璃体切除术后继发黄斑前膜的危险因素分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 181-185.

WANG Huanxia, WANG Shuya, WANG Ying, SUN Xuan, HUANG Jie, WANG Xingrong. Risk factors for epiretinal membrane formation following pars plana vitrectomy for rhegmatogenous retinal detachment[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 181-185.

参考文献 23

[1]	Lee IJ, Benjamin JE, Ghorayeb GR. Incidence of epiretinal membrane formation after pars plana vitrectomy for giant retinal tear-associated retinal detachment[J]. Clin Ophthalmol, 2023, 17: 1415-1420. doi:10.2147/OPTH.S407699.
[2]	Lamas-Francis D, Bande-Rodríguez M, Blanco-Teijeiro MJ. Primary ILM peeling during retinal detachment repair: a systematic review and meta-analysis[J]. Sci Rep, 2023, 13(1): 3586. doi:10.1038/s41598-023-30060-w.
[3]	Fung AT, Galvin J, Tran T. Epiretinal membrane: a review[J]. Clin Exp Ophthalmol, 2021, 49(3): 289-308. doi:10.1111/ceo.13914.
[4]	Patel SN, Salabati M, Mahmoudzadeh R, et al. Surgical failures after primary scleral buckling for rhegmatogenous retinal detachment: Comparison of Eyes With and Without Proliferative Vitreoretinopathy[J]. Retina, 2021, 41(11): 2288-2295. doi:10.1097/iae.0000000000003214.
[5]	Heo MS, Kim HW, Lee JE, et al. The clinical features of macular pucker formation after pars Plana vitrectomy for primary rhegmatogenous retinal detachment repair[J]. Korean J Ophthalmol, 2012, 26(5): 355-361. doi:10.3341/kjo.2012.26.5.355.
[6]	董力, 魏文斌. 增生性玻璃体视网膜病变研究进展[J]. 国际眼科纵览, 2019, 43(2): 138-143. doi:10.3760/cma.j.issn.1673-5803.2019.02.013. DONG Li, WEI Wenbin. Research progress of proliferative vitreoretinopathy[J]. International Review of Ophthalmology, 2019, 43(2): 138-143. doi:10.3760/cma.j.issn.1673-5803.2019.02.013.
[7]	Warren A, Wang DW, Lim JI. Rhegmatogenous retinal detachment surgery: a review[J]. Clin Exp Ophthalmol, 2023, 51(3): 271-279. doi:10.1111/ceo.14205.
[8]	Neuhaus C, Valmaggia C. Postoperative results in the treatment of retinal detachment with scleral buckling surgery[J]. Klin Monbl Augenheilkd, 2023, 240(4): 481-485. doi:10.1055/a-2040-3598.
[9]	Hirakata T, Hiratsuka Y, Yamamoto S, et al. Risk factors for macular pucker after rhegmatogenous retinal detachment surgery[J]. Sci Rep, 2021,11: 18276. doi:10.1038/s41598-021-97738-x.
[10]	Ishida Y, Iwama Y, Nakashima H, et al. Risk factors, onset, and progression of epiretinal membrane after 25-gauge pars plana vitrectomy for rhegmatogenous retinal detachment[J]. Ophthalmol Retina, 2020, 4(3): 284-288. doi:10.1016/j.oret.2019.10.004.
[11]	Katira RC, Zamani M, Berinstein DM, et al. Incidence and characteristics of macular pucker formation after primary retinal detachment repair by pars plana vitrectomy alone[J]. Retina, 2008, 28(5): 744-748. doi:10.1097/IAE.0b013e318162b031.
[12]	Wu F, Eliott D. Molecular targets for proliferative vitreoretinopathy[J]. Semin Ophthalmol, 2021, 36(4): 218-223. doi:10.1080/08820538.2021.1890791.
[13]	Fung AT, Galvin J, Tran T. Epiretinal membrane: a review[J]. Clin Exp Ophthalmol, 2021, 49(3): 289-308. doi:10.1111/ceo.13914.
[14]	林晓芹, 吴苗琴. 特发性视网膜前膜的发病机制及治疗进展[J]. 山东大学耳鼻喉眼学报, 2020, 34(2): 121-128. doi:10.6040/j.issn.1673-3770.0.2019.499. LIN Xiaoqin, WU Miaoqin. Pathogenesis and treatment of idiopathic epiretinal membranes[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(2): 121-128. doi:10.6040/j.issn.1673-3770.0.2019.499.
[15]	Ishikawa K, Akiyama M, Mori K, et al. Drainage retinotomy confers risk of epiretinal membrane formation after vitrectomy for rhegmatogenous retinal detachment repair[J]. Am J Ophthalmol, 2022, 234: 20-27. doi:10.1016/j.ajo.2021.07.028.
[16]	Xiang JJ, Fan JJ, Wang JH. Risk factors for proliferative vitreoretinopathy after retinal detachment surgery: a systematic review and meta-analysis[J]. PLoS One, 2023, 18(10): e0292698. doi:10.1371/journal.pone.0292698.
[17]	Cox MS, Azen SP, Barr CC, et al. Macular pucker after successful surgery for proliferative vitreoretinopathy. Silicone Study Report 8[J]. Ophthalmology, 1995, 102(12): 1884-1891. doi:10.1016/s0161-6420(95)30779-8.
[18]	Kohli GM, Shenoy P, Shetty S, et al. Macular internal limiting membrane peel for eyes undergoing vitrectomy for retinal detachment: Rationalizing selection based on the severity of proliferative vitreoretinopathy[J]. Indian J Ophthalmol, 2021, 69(5): 1356-1357. doi:10.4103/ijo.IJO_500_21.
[19]	Carpineto P, Licata AM, Ciancaglini M. Proliferative vitreoretinopathy: a reappraisal[J]. J Clin Med, 2023, 12(16): 5287. doi:10.3390/jcm12165287.
[20]	Shahlaee A, Woeller CF, Philp NJ, et al. Translational and clinical advancements in management of proliferative vitreoretinopathy[J]. Curr Opin Ophthalmol, 2022, 33(3): 219-227. doi:10.1097/ICU.0000000000000840.
[21]	Martinez Pacheco VA, Rojas Juarez S, Velasco Sepulveda BH, et al. Proliferative vitreoretinopathy and its relationship with inflammatory serum biomarkers[J]. Int J Ophthalmol, 2024, 17(9): 1659-1664. doi:10.18240/ijo.2024.09.13.
[22]	Szigiato AA, Antaki F, Javidi S, et al. Risk factors for epiretinal membrane formation and peeling following pars plana vitrectomy for primary rhegmatogenous retinal detachment, an OCT guided analysis[J]. Int J Retina Vitreous, 2022, 8(1): 70. doi:10.1186/s40942-022-00418-9.
[23]	Fu Y, Xie TH, Gu ZH, et al. The development of epiretinal membrane following rhegmatogenous retinal detachment repair: incidence, risk factors, and outcomes[J]. Arq Bras Oftalmol, 2021, 85(4): 370-376. doi:10.5935/0004-2749.20220032.

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