Interaction Between Surgical Procedure for Repairing Retinal Detachment and Clinical Risk Factors for Proliferative Vitreoretinopathy

Abstract

Purpose: To asses risk factors of proliferative vitreoretinopathy (PVR) and a model for predicting it. Methods: Observational, case-control. 335 patients with non-complicated retinal detachment (RD) were included: 134 developed PVR (Cases); 201 patients did not (Controls). Risk factors for PVR were identified by multivariate analysis. Influence of variables was assayed according to the surgical approach. By logistic regression analysis a model to predict the risk of developing PVR and odds ratio (OR) values for each clinical factor were estimated. Results: Risk was higher in patients > 70 years and with intraocular pressure lower than 14 (OR: 3.84; CI 95%: 2.04–7.30) and in retinal breaks larger than “1 clock hour” (OR: 2.54; CI: 1.28–5.05), extended retinal detachments (OR: 4.01; CI: 1.98–8.10) and reinterventions (OR: 1.55; CI: 1.14–9.22). Scleral surgery also was a risk factor (OR: 3.89; CI: 2.12–7.14) and aphakia/pseudophakia when scleral surgery is performed (OR: 3.33; CI: 1.54–7.22). A model to predict PVR was proposed with these results. Conclusions: Surgical approach modifies risk factors of PVR, and should be taken into account to improve the models for predicting it.

Keywords:

• extrascleral surgery
• proliferative vitreoretinopathy (PVR)
• retinal detachment
• risk factors
• vitrectomy