Risk factors for proliferative vitreoretinopathy after retinal detachment surgery: A systematic review and meta-analysis

Jinjin Xiang; Jingjing Fan; Jiahui Wang

doi:10.1371/journal.pone.0292698

Risk factors for proliferative vitreoretinopathy after retinal detachment surgery: A systematic review and meta-analysis

PLoS One. 2023 Oct 30;18(10):e0292698. doi: 10.1371/journal.pone.0292698. eCollection 2023.

Authors

Jinjin Xiang¹, Jingjing Fan², Jiahui Wang²

Affiliations

¹ Department of Ophthalmology, Jiangdu People's Hospital Affiliated to Medical College of Yangzhou University, Yangzhou, 225200, Jiangsu, China.
² Department of Ophthalmology, Xian First Hospital, Xi'an, 710002, Shaanxi, China.

Abstract

Background: To comprehensively investigate risk factors for proliferative vitreoretinopathy (PVR) after retinal detachment (RD) surgery.

Methods: PubMed, Embase, Cochrane Library, and Web of Science were systematically searched until May 22, 2023. Risk factors included demographic and disease-related risk factors. Odds ratios (ORs) and weighted mean differences (WMDs) were used as the effect sizes, and shown with 95% confidence intervals (CIs). Sensitivity analysis was conducted. The protocol was registered with PROSPERO (CRD42022378652).

Results: Twenty-two studies of 13,875 subjects were included in this systematic review and meta-analysis. Increased age was associated with a higher risk of postoperative PVR (pooled WMD = 3.98, 95%CI: 0.21, 7.75, P = 0.038). Smokers had a higher risk of postoperative PVR than non-smokers (pooled OR = 5.07, 95%CI: 2.21-11.61, P<0.001). Presence of preoperative PVR was associated with a greater risk of postoperative PVR (pooled OR = 22.28, 95%CI: 2.54, 195.31, P = 0.005). Presence of vitreous hemorrhage was associated with a greater risk of postoperative PVR (pooled OR = 4.12, 95%CI: 1.62, 10.50, P = 0.003). Individuals with aphakia or pseudophakia had an increased risk of postoperative PVR in contrast to those without (pooled OR = 1.41, 95%CI: 1.02, 1.95, P = 0.040). The risk of postoperative PVR was higher among patients with macula off versus those with macula on (pooled OR = 1.85, 95%CI: 1.24, 2.74, P = 0.002). Extent of RD in patients with postoperative PVR was larger than that in patients without (pooled WMD = 0.31, 95%CI: 0.02, 0.59, P = 0.036). Patients with postoperative PVR had longer duration of RD symptoms than those without (pooled WMD = 10.36, 95%CI: 2.29, 18.43, P = 0.012).

Conclusion: Age, smoking, preoperative PVR, vitreous hemorrhage, aphakia or pseudophakia, macula off, extent of RD, and duration of RD symptoms were risk factors for postoperative PVR in patients undergoing RD surgery, which may help better identify high-risk patients, and provide timely interventions.

Copyright: © 2023 Xiang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Aphakia*
Humans
Pseudophakia
Retinal Detachment* / etiology
Risk Factors
Vitreoretinopathy, Proliferative* / complications
Vitreoretinopathy, Proliferative* / surgery
Vitreous Hemorrhage

Grants and funding

This research was funded by the project “Histone deacetylase HDAC4 promotes retinal pigment epithelium inflammation and mitochondrial dysfunction in high glucose induced diabetes retinopathy (YNKT202207)” received by Jinjin Xiang. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.