PERSISTENT CORNEAL EPITHELIAL DEFECT AFTER PARS PLANA VITRECTOMY
| Autor: | Ling Yeung, Hsi-Fu Chen, Ko-Jen Yang, Chi-Chin Sun |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pars plana medicine.medical_specialty Visual acuity Adolescent genetic structures medicine.medical_treatment Sulfur Hexafluoride Vitrectomy Endotamponade Ocular herpes Corneal Diseases 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Diabetes mellitus Ophthalmology medicine Humans Silicone Oils Child Aged Retrospective Studies Aged 80 and over Fluorocarbons business.industry Incidence Incidence (epidemiology) Epithelium Corneal Retinal Detachment Retrospective cohort study General Medicine Middle Aged medicine.disease eye diseases Scleral Buckling medicine.anatomical_structure 030221 ophthalmology & optometry Female sense organs medicine.symptom Complication business 030217 neurology & neurosurgery |
| Zdroj: | Retina. 36:148-155 |
| ISSN: | 0275-004X |
| DOI: | 10.1097/iae.0000000000000657 |
| Popis: | Purpose To investigate the incidence, risk factors, and clinical course of persistent corneal epithelial defects (PCED) after pars plana vitrectomy (PPV). Methods The charts of 426 consecutive patients (511 eyes) who received PPV from January 2008 to December 2011 were reviewed. Corneal complications were defined as the presence of corneal epithelial defects, corneal edema, or superficial punctate keratopathy at least 1 week after vitrectomy. The PCED was defined as corneal epithelial defects lasting longer than 2 weeks after vitrectomy despite conventional treatment. The demographic, preoperative, intraoperative, and postoperative data were compared between PCED and non-PCED corneal complication groups to evaluate the risk factors and clinical outcomes. Results Postoperative corneal complications developed in 103 of 460 (22.4%) eyes. Diabetes was associated with postoperative corneal epithelial defects (P = 0.021) and superficial punctate keratopathy (P = 0.022) but not corneal edema (P = 0.925). Among 103 eyes with corneal complications, 21 eyes developed PCED. The eyes with PCED had poor final visual acuity, with 23.8% (5/21) of the eyes in the PCED group having visual acuity of 20/200 or better compared with 51.2% (42/82) of the eyes in the non-PCED group (P = 0.024). Logistic regression analysis demonstrated that diabetes mellitus (P = 0.025), use of perfluoropropane (P = 0.001), and assistance of a first-year resident (P = 0.029) were statistically significant risk factors for PCED after PPV. There was also a high incidence of geographic herpes simplex virus epithelial keratitis among recalcitrant PCEDs lasting longer than 4 weeks (36%, 4/11 eyes). Conclusion The overall incidence of PCED after PPV was 4.8%. Diabetes mellitus, intravitreal tamponade with perfluoropropane, and assistance of a first-year resident were risk factors for PCED after PPV. Persistent corneal epithelial defects after PPV were correlated with poor postoperative visual outcomes. Early and aggressive management is necessary for patients presenting with corneal epithelial defects after vitrectomy to prevent poor outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|