Br J Ophthalmol 2000;84:506-511
( May )
Risk factors for proliferative vitreoretinopathy after primary
vitrectomy: a prospective study
Chee H Kona, Riaz H Y Asariaa, Nicholas L Occlestonb, Peng T Khawa, George W Aylwarda
a Vitreoretinal and
Glaucoma Units, Moorfields Eye Hospital, and Wound Healing Research
Unit, Department of Pathology, Institute of Ophthalmology, London, b Pfizer Central Research Unit, Sandwich,
Kent
Correspondence to: Mr C H Kon, Wound Healing Research Unit, Department of Pathology,
Institute of Ophthalmology, 11-43 Bath Street, London EC1V
9EL chee{at}private.nethead.co.uk
Accepted for publication 13 January 2000
AIM
To assess clinical
variables and vitreous protein as risk factors for the development of
postoperative proliferative vitreoretinopathy (PVR).
METHODS
A prospective
study was conducted on 140 patients with a rhegmatogenous retinal
detachment in whom a primary vitrectomy was performed. 12 clinical
variables were recorded and vitreous samples obtained for measurement
of protein concentration. Univariate and multivariate logistic
regression analysis was used to determine the risk factors for PVR.
RESULTS
Complete data
were available for 136 of 140 patients. 40 of the 136 patients (29.4%)
developed postoperative PVR. Univariate regression revealed that
significant (p<0.05) risk factors included aphakia, presence of
preoperative PVR, size of detachment, the use of silicone oil, and high
vitreous protein level. Multivariate regression analysis revealed only
aphakia (odds ratio 2.72), the presence of preoperative PVR (odds ratio
3.01), and high vitreous protein concentration (odds ratio 1.11) to be
significant (p<0.05) independent, predictive risk factors for the
development of PVR.
CONCLUSIONS
This study
has shown that the significant risk factors for PVR are preoperative
PVR, aphakia, and high vitreous protein levels. Two models (clinical
factors only and clinical factors and vitreous protein) were
constructed to predict the probability of developing postoperative PVR
and may be used to identify those at risk for possible intravitreal
pharmacological treatment.
© 2000 by British Journal of Ophthalmology