Risk factors for epiretinal membrane in eyes with primary rhegmatogenous retinal detachment that received silicone oil tamponade

Pan, Qintuo; Gao, Zhiqiang; Hu, Xuting; Wu, Qi; Zheng, Jinhuan; Zhang, Zongduan

doi:10.1136/bjophthalmol-2021-320121

Cited by 8 publications

(8 citation statements)

References 47 publications

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“…Both reviews included patients with complex cases with advanced PVR, requiring retinectomy and use of silicone oil. We decided to exclude studies involving these patients, as both advanced PVR and silicone oil are known risk factors for postoperative ERM formation 15 , 18 and their inclusion could lead to overestimation of the effects of the intervention. In addition, recent studies have suggested that the current classification of PVR 21 has important limitations: early stages (A or B) are commonly under-reported, there is a certain level of subjectivity and correct classification remains complex in some cases 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for postoperative ERM formation are long axial length, the use of 20G (rather than 23 or 25G) ports, use of silicone oil, high photocoagulation energy, type 2 diabetes and preoperative proliferative vitreoretinopathy (PVR) 15 , 18 . The benefit of ILM peeling should be evaluated by taking into account the varying degrees of surgical complexity and different surgical techniques as well as differences in preoperative macular status (on/off; preoperative ERM) and the rate of PVR.…”

Section: Introductionmentioning

confidence: 99%

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Primary ILM peeling during retinal detachment repair: a systematic review and meta-analysis

Lamas-Francis

Bande-Rodríguez

Blanco-Teijeiro

2023

Sci Rep

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Epiretinal membrane (ERM) formation is a known postoperative complication following retinal detachment (RD) repair surgery. Prophylactic peeling of the internal limiting membrane (ILM) during surgery has been shown to reduce the risk of developing postoperative ERM formation. Some baseline characteristics and degrees of surgical complexity may act as risk factors for ERM development. In this review we aimed to investigate the benefit of ILM peeling in patients without significant proliferative vitreoretinopathy (PVR) who underwent pars plana vitrectomy for RD repair. A literature search using PubMed and various keywords retrieved relevant papers from which data were extracted and analyzed. Finally, the results of 12 observational studies (3420 eyes) were summarized. ILM peeling significantly reduced the risk of postoperative ERM formation (RR = 0.12, 95% CI 0.05–0.28). The groups did not differ in final visual acuity (SMD 0.14 logMAR (95% CI − 0.03–0.31)). The risk of RD recurrence (RR = 0.51, 95% CI 0.28–0.94) and the need for secondary ERM surgery (RR = 0.05, 95% CI 0.02–0.17) were also higher in the non-ILM peeling groups. In summary, although prophylactic ILM peeling appears to reduce the rate of postoperative ERM, this benefit does not translate into consistent visual recovery across studies and potential complications must be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Primary ILM peeling during retinal detachment repair: a systematic review and meta-analysis

Lamas-Francis

Bande-Rodríguez

Blanco-Teijeiro

2023

Sci Rep

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“…ERM was found more frequently in eyes with giant tears, likely due to the higher chances of RPE dispersion and vitreous hemorrhage in these cases [ 25 ]. ERM was also associated with the use of large-caliber vitrectomy probes (23-gauge), which may be related to the complexity of the cases operated using these probes [ 26 ]. ORF was more frequently observed in association with ERM, suggesting that epiretinal traction could impede retinal relaxation after reattachment, favoring ORF formation.…”

Section: Discussionmentioning

confidence: 99%

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

Cicinelli,

Benatti,

Starace

et al. 2023

Ophthalmol Ther

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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. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-023-00811-z.

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“…A key step in achieving this is to identify patients at high risk for PVR development because they would benefit the most. Previous studies have reported multiple clinical risk factors for PVR through univariate and multiple regression analyses, including preoperative PVR, preoperative vitreous hemorrhage, silicone oil (SO) tamponade, large retinal hiatus, choroidal detachment (CD), and excessive cryotherapy [7][8] . However, the results of these studies were frequently inconsistent and contradictory.…”

Section: Introductionmentioning

confidence: 99%

Nomogram for predicting non-proliferative vitreoretinopathy probability after vitrectomy in eyes with rhegmatogenous retinal detachment

Gao¹,

Zhang²,

Ke³

et al. 2023

Int J Ophthalmol

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AIM: To identify the risk factors for postoperative proliferative vitreoretinopathy (PVR) in patients with primary rhegmatogenous retinal detachment (RRD) and develop a nomogram for predicting postoperative PVR-free probability. METHODS: A total of 741 patients (741 eyes) diagnosed with primary RRD who underwent first surgery in the same hospital were retrospectively reviewed and randomly assigned with 521 to the training set and 220 to the validation set. Univariate and multivariate logistic regression analyses were performed in the training cohort to determine risk factors to construct a nomogram for predicting the 3-, 4-, 5-, and 6-month postoperative PVR-free probabilities. Nomogram performance was estimated by the concordance index (C-index), calibration plot, and the area receiver operating characteristic (ROC) curve. RESULTS: A nomogram was constructed based on the preoperative PVR, silicone oil tamponade time (SOTT), photocoagulation energy (PE), retinal tear size (RTS), and hypertension. In the training set, the C-index of the nomogram was 0.896, 0.936, 0.961, and 0.972 at 3, 4, 5, and 6mo, respectively. The C-index values in the validation set were 0.860, 0.936, 0.951, and 0.965 at 3, 4, 5, and 6mo, respectively. Decision-curve analysis indicated that only the 4-, 5-, and 6-month nomograms had significant net benefits over a large threshold probabilities interval. CONCLUSION: Preoperative PVR, SOTT, PE, RTS, and hypertension are significant risk factors for postoperative PVR formation in patients with primary RRD. The proposed nomogram can effectively predict the 4-, 5-, and 6-month PVR-free probabilities after surgery and assist in making clinical decisions during follow-up.

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Risk factors for epiretinal membrane in eyes with primary rhegmatogenous retinal detachment that received silicone oil tamponade

Cited by 8 publications

References 47 publications

Primary ILM peeling during retinal detachment repair: a systematic review and meta-analysis

Primary ILM peeling during retinal detachment repair: a systematic review and meta-analysis

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

Nomogram for predicting non-proliferative vitreoretinopathy probability after vitrectomy in eyes with rhegmatogenous retinal detachment

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