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Article: Surgical failure following primary retinal detachment surgery by vitrectomy: Risk factors and functional outcomes

TitleSurgical failure following primary retinal detachment surgery by vitrectomy: Risk factors and functional outcomes
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. 1234-1238 How to Cite?
AbstractAim: To identify preoperative features associated with surgical failure following vitrectomy using data collected in a large, prospective randomised controlled trial. Outcomes of patients who redetached were then examined in more detail. Methods: 615 patients were analysed as part of an randomised controlled trial investigating the 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. Failure was defined as retinal redetachment within 6 months of primary vitrectomy. Univariate logistic regression analysis was used to assess association between failure and putative risk factors (age, pathological myopia, intraocular pressure, vitreous haemorrhage, previous lens extraction, uveitis, number of retinal quadrants detached, number and distribution of retinal breaks, and grade C proliferative vitreoretinopathy (PVR)). Additional characteristics of patients were then elucidated including number of operations required to achieve retinal reattachment, surgical techniques used and final logMAR visual acuity. Results: 96 patients (15.6%) redetached following surgery, and 37 failed due to PVR. Surgical failure was associated with number of retinal quadrants detached (OR per increase, 1.69 (1.33 to 2.15) p<0.001) and grade C PVR (OR 3.98 (1.47 to 10.73) p=0.006). Inferior breaks were not identified as a risk factor (p=0.602). Repeat retinal detachment surgery showed a trend towards reduced visual acuity at 6 months providing PVR did not develop. PVR resulted in a significant deterioration in visual acuity. Conclusions: The extent of retinal detachment and preoperative PVR are risk factors for surgical failure following vitrectomy for primary retinal detachment. PVR was again confirmed as the major factor influencing visual outcomes.
Persistent Identifierhttp://hdl.handle.net/10722/143950
ISSN
2015 Impact Factor: 3.036
2015 SCImago Journal Rankings: 1.873
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWickham, Len_HK
dc.contributor.authorHoYen, GOen_HK
dc.contributor.authorBunce, Cen_HK
dc.contributor.authorWong, Den_HK
dc.contributor.authorCharteris, DGen_HK
dc.date.accessioned2011-12-21T10:29:28Z-
dc.date.available2011-12-21T10:29:28Z-
dc.date.issued2011en_HK
dc.identifier.citationBritish Journal Of Ophthalmology, 2011, v. 95 n. 9, p. 1234-1238en_HK
dc.identifier.issn0007-1161en_HK
dc.identifier.urihttp://hdl.handle.net/10722/143950-
dc.description.abstractAim: To identify preoperative features associated with surgical failure following vitrectomy using data collected in a large, prospective randomised controlled trial. Outcomes of patients who redetached were then examined in more detail. Methods: 615 patients were analysed as part of an randomised controlled trial investigating the 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. Failure was defined as retinal redetachment within 6 months of primary vitrectomy. Univariate logistic regression analysis was used to assess association between failure and putative risk factors (age, pathological myopia, intraocular pressure, vitreous haemorrhage, previous lens extraction, uveitis, number of retinal quadrants detached, number and distribution of retinal breaks, and grade C proliferative vitreoretinopathy (PVR)). Additional characteristics of patients were then elucidated including number of operations required to achieve retinal reattachment, surgical techniques used and final logMAR visual acuity. Results: 96 patients (15.6%) redetached following surgery, and 37 failed due to PVR. Surgical failure was associated with number of retinal quadrants detached (OR per increase, 1.69 (1.33 to 2.15) p<0.001) and grade C PVR (OR 3.98 (1.47 to 10.73) p=0.006). Inferior breaks were not identified as a risk factor (p=0.602). Repeat retinal detachment surgery showed a trend towards reduced visual acuity at 6 months providing PVR did not develop. PVR resulted in a significant deterioration in visual acuity. Conclusions: The extent of retinal detachment and preoperative PVR are risk factors for surgical failure following vitrectomy for primary retinal detachment. PVR was again confirmed as the major factor influencing visual outcomes.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.rightsThis 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. 1234-1238] 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.meshVisual Acuity - physiologyen_US
dc.subject.meshVitrectomyen_US
dc.titleSurgical failure following primary retinal detachment surgery by vitrectomy: Risk factors and functional outcomesen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0007-1161&volume=95&issue=9&spage=1234&epage=1238&date=2011&atitle=Surgical+failure+following+primary+retinal+detachment+surgery+by+vitrectomy:+risk+factors+and+functional+outcomesen_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.2010.190306en_HK
dc.identifier.pmid21156702-
dc.identifier.scopuseid_2-s2.0-80052127889en_HK
dc.identifier.hkuros197814en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80052127889&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume95en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1234en_HK
dc.identifier.epage1238en_HK
dc.identifier.isiWOS:000294043200011-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridWickham, L=15520285500en_HK
dc.identifier.scopusauthoridHoYen, GO=26632875600en_HK
dc.identifier.scopusauthoridBunce, C=7005268305en_HK
dc.identifier.scopusauthoridWong, D=7401536078en_HK
dc.identifier.scopusauthoridCharteris, DG=7003299563en_HK

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