Abstract
Purpose
To determine the prognostic factors of primary anatomical success after microincisional vitrectomy for rhegmatogenous retinal detachment (RRD).
Methods
The medical records of 206 eyes treated with microincisional vitrectomy for RRD from 2009 to 2014 were retrospectively reviewed. The preoperative factors (best corrected visual acuity, break sites, number of breaks, break size, extent of retinal detachment, high myopia, lens status) and intraoperative factors (combined cataract surgery, vitrectomy machine, tamponade, sclerotomy size) were investigated to determine correlations with primary anatomical success.
Results
Of the 206 eyes, 198 eyes (96.1%) were reattached after primary vitrectomy; 46 eyes of 48 eyes with inferior breaks (95.8%, p = 1.000), 42 eyes of 44 pseudophakic eyes (95.5%, p = 1.000), 84 eyes of 89 eyes with multiple breaks (95.4%, p = 0.296). All 39 eyes using air tamponade (100%, p = 0.224) were reattached and there was no significant correlation with primary anatomical success. Conversely, 44 eyes of 49 eyes with high myopia (89.8%) were reattached after primary surgery, which was lower than non-high myopic eyes (98.1%, p = 0.028). Multivariate logistic regression showed that high myopia was an independent factor for primary reattachment failure (odds ratio = 5.795, 95% confidence interval = 1.332–25.208, p = 0.019).
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Table 1.
Baseline characteristics
Table 2.
Operative methods
Table 3.
Correlation between variables with primary reattachment rate
Success | Fail | p-value | |
---|---|---|---|
Gender | 0.451* | ||
Male | 131 (97.0) | 4 (3.0) | |
Female | 67 (94.3) | 4 (5.7) | |
BCVA at first visit (log MAR) | 1.000* | ||
<1.40 | 100 (96.1) | 4 (3.9) | |
≥1.40 | 98 (96.1) | 4 (3.9) | |
Macula status | 0.241* | ||
Off | 132 (95.0) | 7 (5.0) | |
On | 66 (98.5) | 1 (1.5) | |
Lens | 0.569* | ||
Phakic | 156 (96.3) | 6 (3.7) | |
Pseudophakic | 42 (95.5) | 2 (4.5) | |
High myopia | 0.028* | ||
No (<26 mm) | 154 (98.1) | 3 (1.9) | |
Yes (≥26 mm) | 44 (89.8) | 5 (10.2) | |
Number of breaks | 0.519* | ||
<2 | 114 (97.4) | 3 (2.6) | |
≥2 | 84 (94.4) | 5 (5.6) | |
Site of breaks | 0.292* | ||
Other than no Inferior breaks | 152 (96.2) | 6 (3.8) | |
Inferior breaks | 46 (95.8) | 2 (4.2) | |
Gauge | 0.962* | ||
23 | 147 (96.1) | 6 (3.9) | |
25 | 51 (96.2) | 2 (3.8) | |
Equipment | 0.960* | ||
ACCURUS® | 122 (96.1) | 5 (3.9) | |
Constillation® | 76 (96.2) | 3 (3.8) | |
Tamponade | 0.137† | ||
Air | 39 (100.0) | 0 (0.0) | |
Gas | 147 (95.5) | 7 (4.5) | |
Silicone oil | 12 (92.3) | 1 (7.7) |