Intra- and post-operative risk of retinal breaks during vitrectomy for macular hole and vitreomacular traction

• Published in: PloS one 2022-08, Vol.17 (8), p.e0272333
• Main Authors: Jairath, Neil K, Paulus, Yannis M, Yim, Angela, Zhou, Yunshu, Parekh, Bela J, Jairath, Ruple, Musch, David C, Rosenthal, Julie M
• Format: Article
• Language: English
• Subjects: Care and treatment; Complications and side effects; Diabetic retinopathy; Diagnosis; Epiretinal Membrane - diagnosis; Epiretinal Membrane - surgery; Gauges; Health risks; Humans; Medical diagnosis; Medical records; Medicine and Health Sciences; Myopia; Patient outcomes; Patients; Physical Sciences; Retina; Retinal diseases; Retinal Perforations - surgery; Retrospective Studies; Risk analysis; Risk factors; Statistical analysis; Tomography, Optical Coherence; Traction; Variables; Vision Disorders - surgery; Vitrectomy; Vitrectomy - adverse effects
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0272333

To evaluate the development of intra- and post-operative retinal breaks after pars plana vitrectomy (PPV) for macular hole (MH) and/or vitreomacular traction (VMT). Medical records of patients who underwent PPV at Kellogg Eye Center between 1/1/2005-6/30/2018, were evaluated in three groups: group 1, MH/VMT (n = 136); group 2, epiretinal membrane (ERM) without VMT (n = 270); and group 3, diagnostic vitrectomy (DV) or vitreous opacities (n = 35). Statistical analyses were conducted using SAS. 20.6% of patients with MH/VMT, 8.5% of patients with ERM, and 5.7% of patients with DV or vitreous opacities had either intra-operative or post-operative breaks. Indication of MH/VMT versus ERM was a significant predictor for this outcome (p = .0112). The incidence of retinal breaks was higher in operations using 23-gauge versus 25-gauge PPV (25.0% vs. 7.4%, p < .0001). The presence of MH and/or VMT is a significant risk factor for retinal breaks from PPV, as is use of 23-gauge vitrectomy.