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Article: Retinal detachment repair by vitrectomy: Simplified formulae to estimate the risk of failure

TitleRetinal detachment repair by vitrectomy: Simplified formulae to estimate the risk of failure
Authors
Issue Date2011
PublisherBMJ Publishing Group. The Journal's web site is located at http://bjo.bmjjournals.com/
Citation
British Journal Of Ophthalmology, 2011, v. 95 n. 9, p. 1239-1244 How to Cite?
AbstractAim: Devise simplified formulae, using preoperative clinical data, to give risk estimates of (1) failure and (2) proliferative vitreoretinpathy (PVR) following primary retinal detachment repair by vitrectomy. Methods: 641 patients were analysed as part of an RCT investigating use of 5-fluorouracil and low-molecular-weight heparin. Treatment status had no effect on success rates and did not therefore form part of the analyses. Preoperative risk factors for surgical failure and for PVR within 6 months of retinal detachment surgery were identified, and a multiple variable logistic regression model developed. Further analyses were performed to devise a simple points system to produce risk estimates of failure. Results: Three risk factors were related to failure - previous lens extraction (p=0.046), grade C PVR (p=0.039) and extent of detachment (p<0.001). Three risk factors were also related to failure due to PVR - vitreous haemorrhage (p=0.088), grade C PVR (p=0.044) and extent of detachment (p<0.001). There was good agreement between risk estimates produced by the points system and those calculated directly using a multivariate regression model. The points-system model gave an area under the receiver operating characteristic curve of 0.658. The receiver operating characteristic curve for the PVR model gave an area under the curve of 0.8399 suggesting greater diagnostic value. Conclusions: A simple points system may be used as a clinical guide to identify patients at higher risk of failure following retinal detachment repair by vitrectomy. This may help clinicians select appropriate surgical approaches and stratify cases in research and surgical training.
Persistent Identifierhttp://hdl.handle.net/10722/143949
ISSN
2015 Impact Factor: 3.036
2015 SCImago Journal Rankings: 1.873
ISI Accession Number ID
Funding AgencyGrant Number
Royal College of Surgeons Edinburgh
Royal Blind School Edinburgh/Scottish War Blinded
W.H. Ross Foundation for the Prevention of Blindness
Chief Scientist Office ScotlandCZB/4/705
Department of Health through National Institute for Health Research
Funding Information:

This study was supported by a major Ophthalmology grant from the Royal College of Surgeons Edinburgh, the Royal Blind School Edinburgh/Scottish War Blinded, the W.H. Ross Foundation for the Prevention of Blindness and the Chief Scientist Office Scotland (CZB/4/705). The authors acknowledge (a proportion of their) financial support from the Department of Health through the award made by the National Institute for Health Research to Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology for a Specialist Biomedical Research Centre for Ophthalmology. The views expressed in this publication are those of the authors and not necessarily those of the Department of Health.

References

 

DC FieldValueLanguage
dc.contributor.authorWickham, Len_HK
dc.contributor.authorBunce, Cen_HK
dc.contributor.authorWong, Den_HK
dc.contributor.authorCharteris, DGen_HK
dc.date.accessioned2011-12-21T10:29:27Z-
dc.date.available2011-12-21T10:29:27Z-
dc.date.issued2011en_HK
dc.identifier.citationBritish Journal Of Ophthalmology, 2011, v. 95 n. 9, p. 1239-1244en_HK
dc.identifier.issn0007-1161en_HK
dc.identifier.urihttp://hdl.handle.net/10722/143949-
dc.description.abstractAim: Devise simplified formulae, using preoperative clinical data, to give risk estimates of (1) failure and (2) proliferative vitreoretinpathy (PVR) following primary retinal detachment repair by vitrectomy. Methods: 641 patients were analysed as part of an RCT investigating use of 5-fluorouracil and low-molecular-weight heparin. Treatment status had no effect on success rates and did not therefore form part of the analyses. Preoperative risk factors for surgical failure and for PVR within 6 months of retinal detachment surgery were identified, and a multiple variable logistic regression model developed. Further analyses were performed to devise a simple points system to produce risk estimates of failure. Results: Three risk factors were related to failure - previous lens extraction (p=0.046), grade C PVR (p=0.039) and extent of detachment (p<0.001). Three risk factors were also related to failure due to PVR - vitreous haemorrhage (p=0.088), grade C PVR (p=0.044) and extent of detachment (p<0.001). There was good agreement between risk estimates produced by the points system and those calculated directly using a multivariate regression model. The points-system model gave an area under the receiver operating characteristic curve of 0.658. The receiver operating characteristic curve for the PVR model gave an area under the curve of 0.8399 suggesting greater diagnostic value. Conclusions: A simple points system may be used as a clinical guide to identify patients at higher risk of failure following retinal detachment repair by vitrectomy. This may help clinicians select appropriate surgical approaches and stratify cases in research and surgical training.en_HK
dc.languageengen_US
dc.publisherBMJ Publishing Group. The Journal's web site is located at http://bjo.bmjjournals.com/en_HK
dc.relation.ispartofBritish Journal of Ophthalmologyen_HK
dc.rightsBritish Journal of Ophthalmology. Copyright © BMJ Publishing Group.en_US
dc.rightsLocked and research funded articles acknowledgement: This article has been accepted for publication in British Journal of Ophthalmology. The definitive copyedited, typeset version British Journal of Ophthalmology, 2011, v. 95 n. 9, p. 1239-1244 is available online at: http://bjo.bmj.com-
dc.subject.meshFluorouracil - therapeutic useen_US
dc.subject.meshHeparin, Low-Molecular-Weight - therapeutic useen_US
dc.subject.meshRetinal Detachment - drug therapy - physiopathology - surgeryen_US
dc.subject.meshRisk Assessment - methodsen_US
dc.subject.meshVitreoretinopathy, Proliferative - epidemiology - etiology - prevention and controlen_US
dc.titleRetinal detachment repair by vitrectomy: Simplified formulae to estimate the risk of failureen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0007-1161&volume=95&issue=9&spage=1239&epage=1244&date=2011&atitle=Retinal+detachment+repair+by+vitrectomy:+simplified+formulae+to+estimate+the+risk+of+failureen_US
dc.identifier.emailWong, D: shdwong@hku.hken_HK
dc.identifier.authorityWong, D=rp00516en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1136/bjo.2010.190314en_HK
dc.identifier.pmid21325394-
dc.identifier.scopuseid_2-s2.0-80052105632en_HK
dc.identifier.hkuros197812en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80052105632&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume95en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1239en_HK
dc.identifier.epage1244en_HK
dc.identifier.isiWOS:000294043200012-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridWickham, L=15520285500en_HK
dc.identifier.scopusauthoridBunce, C=7005268305en_HK
dc.identifier.scopusauthoridWong, D=7401536078en_HK
dc.identifier.scopusauthoridCharteris, DG=7003299563en_HK

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