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.

相关文章 15

[1]	宋艳玲,司元元,崔彦. 微量玻璃体切除治疗激光笔致儿童全层黄斑裂孔1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 144-147.
[2]	李致富,高玉. 玻璃体切除术后视野缺损的机制研究及预防[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 168-176.
[3]	肖哲,张胜娟,赵子琦,兴辰,李成泉,刘志强. Ultra Q:YAG激光治疗黄斑部视网膜前出血17例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 130-135.
[4]	张琳,辛运超,尚小领,解琪,刘亚超. cN0期甲状腺微小乳头状癌颈部中央区及侧颈区淋巴结转移率、危险因素及清扫策略的临床研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 62-69.
[5]	孟素坤,张纯. 小梁消融术治疗开角型青光眼患者的长期视野缺损研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 139-148.
[6]	李璐,赵杰,赵博军. 中心性浆液性脉络膜视网膜病变的发病机制与治疗研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 118-124.
[7]	李智林,郑洲,安韡. 12例原发性甲状腺鳞状细胞癌的临床及生存分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 59-63.
[8]	肖富亮,林云,潘新良. 早期cN0 PTC预防性中央区淋巴结清扫的临床研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 64-71.
[9]	李爱军,崔小梅. 白内障术前房颤人群综合路径管理现状横断面调查[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 38-44.
[10]	李曼,王艳玲,赵露. 白内障术后粪肠球菌眼内炎1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 56-59.
[11]	张礼俊, 胥然, 罗继芳, 刘国旗, 何千, 李玮, 蒋振华. 头颈肿瘤游离皮瓣修复术后皮瓣坏死及皮瓣相关并发症影响因素分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 86-90.
[12]	刘珊珊, 韩书婧, 王晓旭, 李艳红, 倪鑫, 张杰. 儿童细菌性脑膜炎后听力损害危险因素的系统评价与Meta分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 48-54.
[13]	鹿文瑞,严端,许诺. 25G玻璃体切除治疗上方孔源性视网膜脱离的疗效[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 89-91.
[14]	周怀胜,梁婉玲,郎海波,冼志林,晏世刚,孔祥斌,沈沛阳. 超广角眼底照相在孔源性视网膜脱离患者术前检查的临床应用[J]. 山东大学耳鼻喉眼学报, 2021, 35(3): 96-99.
[15]	杨秀芬,尤冉,马秀梅,王康,王艳玲. 以医院为基础的中心性浆液性脉络膜视网膜病变流行病学调查及危险因素的研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 75-79.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed