Clinical Outcomes of Rhegmatogenous Retinal Detachment Treated With Pneumatic Retinopexy.
Clinical Outcomes of Rhegmatogenous Retinal Detachment Treated With Pneumatic Retinopexy.
复制标题
气压式视网膜固定术治疗孔源性视网膜脱离的临床结果。
作者：
Nicolas A. Yannuzzi;Charles Li;Danielle Fujino;S. Kelly;F. Lum;H. Flynn;D. Parke
重要性
气动视网膜固定术（PR）是唯一基于临床的孔源性视网膜脱离（RRD）修复方法。尚未报告注册处通过该程序获得的临床实践设置结果数据。
目的
描述主要采用 PR 治疗的 RRD 相关的临床结果。
设计、设置和参与者
在这项回顾性队列研究中，分析了参加美国眼科学会 IRIS 登记处（视力智能研究）的学术和私人眼科诊所接受治疗的 19 岁及以上非复杂性 RRD 患者的数据。数据采集时间为2013年1月1日至2019年12月31日，数据分析时间为2020年1月至12月。
曝光
对因非复杂性 RRD 接受 PR 并进行至少 3 个月随访的眼睛从 IRIS 登记处查询数据。通过 RRD 诊断代码和 PR 现行程序术语代码的组合来识别病例。
主要成果和措施
实现单次手术成功 (SOS) 的眼睛数量，定义为无需后续视网膜脱离手术或重复 PR 即可实现视网膜复位。
结果
在 9553 名患者中，5827 名 (61.0%) 为男性，平均 (SD) 年龄为 62 (10) 岁。总共识别出9659只眼睛。 6613 只眼睛 (68.5%) 获得了 SOS。治疗后 9 至 12 个月，SOS 组和单次手术失败组的最佳矫正视力存在显着差异，平均为 0.24 logMAR（95% CI，0.23-0.25；近似 Snellen 等效值，20/35），单次手术失败组平均为 0.43 logMAR（95% CI，0.40-0.46；近似 Snellen 等效值，20/35）。 20/54）。在所有患者中，最大视力恢复的平均时间为 268 天（95% CI，260-276）。 3只眼（0.03%）出现眼内炎。 SOS 与女性性别相关（比值比，1.51；95% CI，1.38-1.65），而当前吸烟状况与单次手术失败相关（比值比，0.78；95% CI，0.68-0.91）。
结论和相关性
这项基于登记的研究涵盖了来自多个异构电子健康记录系统的大量眼睛，在经过初级 PR 治疗的非复杂 RRD 眼睛中，68.5% 的眼睛实现了 SOS。目前尚不清楚这些结果与该队列中其他 RRD 修复方法相比如何。
Importance
Pneumatic retinopexy (PR) is the only clinic-based method of rhegmatogenous retinal detachment (RRD) repair. Registry-acquired clinical practice setting outcomes data with this procedure have not yet been reported.
Objective
To describe the clinical outcomes associated with RRD treated primarily with PR.
Design, Setting, and Participants
In this retrospective cohort study, data from patients 19 years and older with noncomplex RRD treated at academic and private ophthalmology practices participating in the American Academy of Ophthalmology IRIS Registry (Intelligent Research in Sight) were analyzed. Data were collected from January 1, 2013, to December 31, 2019, and data were analyzed from January to December 2020.
Exposures
Data from the IRIS Registry were queried for eyes that underwent PR for noncomplex RRD and had at least 3 months of follow-up. Cases were identified by a combination of diagnosis code for RRD and a Current Procedural Terminology code for PR.
Main Outcomes and Measures
The number of eyes that achieved single-operation success (SOS), defined as retinal reattachment without a subsequent retinal detachment surgery or repeated PR.
Results
Of 9553 included patients, 5827 (61.0%) were male, and the mean (SD) age was 62 (10) years. A total of 9659 eyes were identified. SOS was achieved in 6613 eyes (68.5%). Best-corrected visual acuity significantly differed 9 to 12 months after treatment between the SOS group, with a mean of 0.24 logMAR (95% CI, 0.23-0.25; approximate Snellen equivalent, 20/35), and the single-operation failure group, with a mean of 0.43 logMAR (95% CI, 0.40-0.46; approximate Snellen equivalent, 20/54). Among all patients, the mean time to maximal visual recovery was 268 days (95% CI, 260-276). Endophthalmitis was observed in 3 eyes (0.03%). SOS was associated with female sex (odds ratio, 1.51; 95% CI, 1.38-1.65), while current smoking status was associated single-operation failure (odds ratio, 0.78; 95% CI, 0.68-0.91).
Conclusions and Relevance
In this registry-based study, which encompasses a large number of eyes drawn from multiple, heterogenous electronic health record systems, SOS was achieved in 68.5% of eyes with noncomplex RRD treated by primary PR. It is unknown how these outcomes would have compared with other methods of RRD repair in this cohort.