Prevalence and risk factors for proliferative vitreoretinopathy in eyes with rhegmatogenous retinal detachment but no previous vitreoretinal surgery

Abstract

PurposeTo determine the prevalence of and risk factors for proliferatative vitreoretinopathy (PVR) in eyes with rhegmatogenous retinal detachment but no previous vitreoretinal surgery. DesignObservational case series. MethodsProspective study. SettingA private vitreoretinal clinic in Caracas, Venezuela. Study population119 eyes of 119 patients who presented with rhegmatogenous retinal detachment but no previous vitreoretinal surgery between 1995 and 1998. Observation proceduresData from detailed preoperative and postoperative examinations of each eye were recorded prospectively and entered into an electronic database. Main outcome measuresPrevalence of PVR of any type and severe PVR, preoperative risk factors for PVR of any type and severe PVR, effect of PVR and retinal detachment duration on initial and final visual acuity, and surgical complexity. ResultsThe prevalence of PVR of any type was 52.9% and of severe PVR was 26.9%. The mean retinal detachment duration (±SD) was 58.4 (±129.1) days, and the mean time from initial examination to surgical treatment (±SD) was 24.3 (81.2) days. By univariable analysis, long retinal detachment duration, poor initial visual acuity, and large retinal detachment extent were significantly associated with PVR prevalence and severity. The presence of vitreous hemorrhage was significantly associated with PVR prevalence, and cataract was significantly associated with PVR severity. By multivariable analysis, long retinal detachment duration and large retinal detachment extent were simultaneous risk factors for PVR prevalence, while long retinal detachment, large retinal detachment extent, and poor initial visual acuity were simultaneous risk factors for PVR severity. Eyes with longer retinal detachment duration, PVR of any type, and severe PVR had worse initial and final visual acuities than eyes with shorter retinal detachment duration or those without PVR, respectively. Eyes with PVR had more complex surgery than those without PVR. ConclusionsPVR occurred very frequently in this population and was associated with more complex surgery and worse visual outcomes than among eyes without PVR. We have identified preventable risk factors associated with PVR that suggest a specific and significant need for better access to ophthalmologic care and patient education in this group of patients.