组织型纤溶酶原激活剂、肝素和高三尖杉酯碱对 术后增生性玻璃体视 网膜病变的抑制作用

目的观察组织型纤溶酶原激活剂(tissue plasminogen acti vator,t-PA)、肝素和高三尖杉酯碱联合用药对术后增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)的抑制效果。方法43例44 只眼接受玻璃体视网膜手术的复杂性视网膜脱离患者,根据手术及是否同时球内联合用药分为 A、B两组(A组为用药组,B组为对照组)。随访观察两组术后PVR再发生及视网膜脱离复发情况,平均随访期为7．9个月。结果PVR发生率：A组15.8%,B组45.5%,χ² 检验,P＜0.05。视网膜脱离复发率A组5.5%,B组33.3%,χ² 检验,P＜0.05。结论手术辅以球内联合用药可有效抑制术后PVR再形成,降低视网膜脱离复发率。(中华眼底病杂志,2001,17:24-25)     

显微镜直视下巩膜外冷凝联合眼内光凝治疗巨大裂孔性视网膜脱离

目的探讨应用显微镜直视下巩膜外冷凝联合眼内光凝玻璃体切割术治疗巨大裂孔性视网膜脱离手术效果。方法巨大裂孔性视网膜脱离患者19例19眼均行玻璃体切割、手术显微镜直视下巩膜外冷凝联合眼内光凝,玻璃体腔填充硅油进行治疗。术后进行随访。结果术后随访6～36个月,平均21.3个月,15例视网膜完全复位(78.9%);视网膜在术后2周至5个月因术后增生性玻璃体视网膜病变的形成导致视网膜裂孔开放而发生再脱离4例(21.1%);完全复位者有11例取出硅油,其中有1例复发;术后6个月视力较术前好转15例,不变3例,仅有1例下降,术后盲目率(26.3%)与术前(78.9%)比较有显著性下降(χ2=10.5263,P<0.05)。术后发生白内障6例,高眼压5例,视网膜下出血3例,玻璃体腔出血2例,角膜带状变性1例。结论应用显微镜直视下巩膜外冷凝联合眼内光凝治疗巨大裂孔性视网膜脱离,术后可得到满意的视网膜复位率及脱盲率。     

氟尿嘧啶联合低分子肝素防治增殖性玻璃体视网膜病变的临床观察

目的评价氟尿嘧啶联合低分子肝素在预防玻璃体切割术后增殖性玻璃体视网膜病变发生过程中的安全性和有效性。方法本研究随机选择本科2003．4～2003．11间需行玻璃体手术治疗的视网膜脱离患者50例50眼，病例选用标准为具有玻璃体术后视网膜脱离复发的高危因素的患者，分成治疗组与对照组，治疗组灌注液中加入低分子肝素和氟尿嘧啶，药物灌注时间控制在35～45分钟之间，随访3个月，对两组结果进行对比分析结果随访3个门后，治疗组与对照组术后增殖性玻璃体视网膜病变的发生率分别为8％(2／25)和36%(9/25)，有显著性差异(P=0．041),治疗组术后因PVR造成的视网膜脱离复发率为4％(1／25)，对照组为16%(4／25)，治疗组1例和对照组4例患者成功的进行了视网膜的再次复位手术。没有发现有明显的与药物有关的眼部并发症。结论虽然术后3个月时两组视网膜脱离的复发率差异没有统计学意义，但治疗组术后增殖性玻璃体视网膜病变的发生率较对照组有意义的减少。本试验显示了手术联合氟尿嘧啶与低分子肝素可以预防术后PVR的发生。     

巨大裂孔性视网膜脱离的治疗

目的 探讨现代玻璃体视网膜手术治疗巨大裂孔性视网膜脱离的疗效,及提高其疗效的方法.方法 回顾分析巨大裂孔性视网膜脱离50眼,其中巨大视网膜撕裂孔36眼,巨大锯齿缘截离14眼.采用现代显微玻璃体视网膜手术眼内填充的方法,其中14眼周边360.光凝;26眼注入硅油,24眼注入C3F8 气体;6眼巩膜外加压及环扎.结果 出院时49眼视网膜解剖复位(98.0%);39眼随访6-36个月,视网膜解剖复位30服(76.9%),其中7眼经过再次手术治愈,最后复位37眼(94.9%).两组巨大裂孔性视网膜脱离治疗的疗效经统计学Fisher's精确概率法处理差异无统计学意义(P＜0.05);术后主要并发症:黄斑前膜2眼,视网膜前膜4眼,视网膜裂孔2眼.结论 巨大裂孔性视网膜脱离术后失败主要原因为下方增殖性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)发展和巨孔一端或下端裂孔再开放.为了提高疗效,建议术中彻底切除玻璃体,包括基底部玻璃体切除,剥净视网膜前、后增殖膜;对下方＜150°巨大裂孔,术前aPVR明显或术中增殖膜未取干净者,同时行巩膜环扎术;应用周边360°光凝,可避免术后继发视网膜再撕裂.     

玻璃体切割术联合视网膜光凝或内界膜剥除术治疗黄斑裂孔性视网膜脱离的疗效分析

目的 对比分析玻璃体切割术联合视网膜光凝或内界膜剥除术治疗黄斑裂孔性视网膜脱离的临床疗效.方法 回顾性分析我院2008年1月至2010年12月收治的黄斑裂孔性视网膜脱离患者64例(64眼)的临床资料,其中行玻璃体切割术联合视网膜光凝患者32例(联合光凝组),行玻璃体切割术联合内界膜剥除术患者32例(联合剥除组),术后随访6～24个月,观察两组患者随访末期视网膜复位情况、视力变化及并发症情况.结果 联合光凝组术后视网膜裂孔封闭、视网膜解剖复位率为59.4％,联合剥除组复位率为81.3％,差异有显著统计学意义(均为P＜0.01).2组术后视力均较术前明显提高,差异均有显著统计学意义(均为P ＜0.01),但联合剥除组术后视力恢复情况明显好于联合光凝组,差异有统计学意义(P＜0.05).联合光凝组并发症主要有视网膜轻度出血、继发性青光眼等,联合剥除组为术中轻度视网膜损伤、术后一过性高眼压等.结论 玻璃体切割联合内界膜剥除术治疗黄斑裂孔性视网膜脱离的临床疗效好于玻璃体切割联合视网膜光凝.     

马蹄形裂孔性视网膜脱离的一次性玻璃体视网膜手术

目的 对比观察玻璃体视网膜手术和巩膜外手术对马蹄形裂孔性视网膜脱离的临床疗效。方法 对102例(102只眼)视网膜脱离采用巩膜外手术，包括环扎加压、巩膜外加压术或加用眼内注气。176例(176只眼)采用玻璃体视网膜手术，眼内光凝、放液，分别对比两者的初次解剖复位率(3个月内)、复发率(3个月以上)、视力、并发症及其影响因素。结果 两组初次解剖复位率大致相同，但巩膜外手术组网脱复发率高于玻璃体视网膜手术组，玻璃体视网膜手术组视力提高幅度大，黄斑皱襞发生率低，屈光乱视发生少，但白内障发生率较高。两者上述项目对比有显著差异(P＜0．05)。结论 对于牵拉性质不伴有严重的增生性玻璃体视网膜病变的马蹄形裂孔性视网膜脱离，从视功能恢复角度出发，对熟练的玻璃体手术经验者可把玻璃体视网膜手术作为首要选择。     

孔源性视网膜脱离术后增生性玻璃体视网膜病变形成的危险因素

目的 分析孔源性视网膜脱离玻璃体手术后增生性玻璃体视网膜病变(PVR)形成的危险因素。方法 孔源性视网膜脱离110例(112眼)行玻璃体切割术，术后随访6—32个月(平均8．4个月)。结果 112眼中34眼(30.4％)形成术后PVR。多因素逐步回归分析显示，术前PVR为影响术后PVR形成的重要危险因素(P＝0．001)，而硅油填充、巨大视网膜裂孔、合并脉络膜脱离等因素与术后PVR的形成无显著相关。术前PVR者手术成功率明显降低。结论 影响术后PVR形成的重要危险因素为术前PVR。对于有术前PVR可能导致术后PVR形成的高危人群可行预防性治疗。     

高度近视黄斑裂孔视网膜脱离的玻璃体手术和激光光凝治疗

目的 探讨高度近视黄斑裂孔视网膜脱离患者玻璃体手术联合激光光凝治疗的成功率及并发症。 方法 高度近视黄斑裂孔视网膜脱离患者35例38只眼，11例12只眼单行经睫状体平部的玻璃体手术及惰性气体眼内填充，未作激光光凝治疗；24例26只眼在玻璃体手术术中及术后作黄斑裂孔缘激光光凝。术后均作6个月以上的随访(平均随访时间21．7个月)。 结果 非光凝组5只眼黄斑裂孔性视网膜脱离复发，占41．7%，术后0．1以上视力6只眼，占50.0%；光凝组2只眼黄斑裂孔复发，占7.7%，1只眼因周边新裂孔形成而复发视网膜脱离，术后有13只眼视力在0.1以上，占50.0%。统计学检验两组黄斑裂孔复发率概率P=0.024,视网膜脱离复发率概率P=0.0487。两组患者术后视力无显著差异。 结论 玻璃体手术联合黄斑区激光光凝治疗可提高高度近视黄斑裂孔视网膜脱离的手术成功率。 (中华眼底病杂志,1998,14:199-201)     

高度近视黄斑裂孔性视网膜脱离合并脉络膜脱离的相关因素分析

目的 探讨高度近视黄斑裂孔性视网膜脱离合并脉络膜脱离的相关危险因素,总结其临床特点及治疗方法.方法 连续收集合并脉络膜脱离的高度近视黄斑裂孔性视网膜脱离的病例10例(A组),并以同一时期不伴脉络膜脱离的高度近视黄斑裂孔性视网膜脱离病例12例为对照(B组),对比两组发病年龄、病程、术前屈光度、眼轴、眼压、视网膜脱离范围以及术后视网膜复位、视功能恢复等情况.结果 A组发病年龄大、近视度数高、眼压低、视网膜脱离范围大,与B组相比差异有统计学意义(P<0.05),其中眼压差异显著(P<0.01);两组的一次玻璃体切割手术视网膜复位率相近,A组为80%,B组为83%,但A组术后视力≥0.02的比例低(P=0.048).结论 高度近视黄斑裂孑L性视网膜脱离一旦合并脉络膜脱离常伴有年龄大、病程长、近视度数高、视网膜脱离广泛和显著低眼压等特点.适时采用玻璃体切割合并硅油填充术可达到与不合并脉络膜脱离组相近的视网膜复位率,但视力预后仍较差.     

脉络膜脱离型视网膜脱离的手术疗效分析

目的　探讨脉络膜脱离型视网膜脱离的手术疗效。方法　回顾 2 0 0 0年 10月～ 2 0 0 1年 10月间 ,本院收治的 12例 (12只眼 )脉络膜脱离型视网膜脱离的临床资料 ,分析手术方式、术前激素的治疗、PVR等因素与手术疗效的关系。结果　 15 9例 (92 % )本组 12只眼随访 3～ 6个月 ,10只眼治愈 ,2只眼复发。治愈率为 83.3% ,低于一般孔源性视网膜脱离的治愈率。结论　脉络膜脱离型视网膜脱离是一种复杂性视网膜脱离 ,PVR发展快 ,术前应及时给予激素治疗 ,PVRA、B级及部分 C1 级可行巩膜扣带术 ,术中尽量不放视网膜下液 ,PVR部分 C1～ 3、D级应行玻璃体切除术     

Preoperative vitreous hemorrhage associated with rhegmatogenous retinal detachment: a risk factor for postoperative proliferative vitreoretinopathy?

Background: We conducted a prospective clinical study to elucidate the role of preoperative vitreous hemorrhage in the development of postoperative proliferative vitreoretinopathy (PVR) in primary rhegmatogenous retinal detachment. Materials and methods: We prospectively evaluated 409 eyes of 390 patients affected by primary rhegmatogenous retinal detachment referred before any failed attempt to reattach the retina. Single and multiple logistic regression analysis were used to test 14 categories of variables. Results: Postoperative PVR occurred in 48 (11.7% of 409 eyes). Postoperative PVR developed in 41 (11.8%) of the 347 eyes with no preoperative vitreous hemorrhage, and 7 (11.3%) of the 62 eyes with preoperative vitreous hemorrhage (P=0.90). The results of multiple logistic regression analysis showed that only four variables were significant factors which had independently and jointly an effect on the risk of postoperative PVR: (1) 90° or greater circumferential extent of the retinal tears; (2) preoperative PVR grade B; (3) preoperative PVR grade C-D; and (4) the use of cyrotreatment as the method of retinopexy. Conclusion: With the surgical techniques currently used, mild preoperative vitreous hemorrhage is not an independent risk factor for postoperative PVR in primary rhegmatogenous retinal detachment. The role of moderate and severe vitreous hemorrhage remains to be fully evaluated in a larger series of eyes.     

Comparative study of incomplete posterior vitreous detachment as a risk factor for proliferative vitreoretinopathy

· Background: Abnormal vitreoretinal relationships have recently been implicated in many vitreoretinal disorders. Sites of abnormal vitreoretinal adherences are likely to exist in eyes predisposed to rhegmatogenous retinal detachment (RD), causing either retinal tears or incomplete posterior vitreous detachment (PVD). The present study was designed in two parts to identify the risk for preoperative and postoperative proliferative vitreoretinopathy (PVR) due to incomplete PVD. · Methods: We prospectively evaluated the vitreoretinal relationships using high-resolution kinetic echography in 102 consecutive eyes of 100 patients with rhegmatogenous RD. In the first part, a case-control study was conducted to compare the vitreous status in patients with preoperative PVR (cases) with that in patients with non-PVR-complicated RD (controls). During the second part, patients with noncomplicated RD (65 eyes) who were operated on by a simple retinal attachment procedure were followed up for a mean period of 6.6 months to compare the recurrence of RD due to postoperative PVR according to their vitreous status. · Results: Patients with PVR on study entry had a higher prevalence of partial PVD (28 of 32 eyes, 87%) than did controls (25 of 70 eyes, 35%). The statistical significance of this difference was independent of all other variables studied. After a mean follow-up period of 6.6 months, the incidence of recurrence of RD associated with postoperative PVR was 33% in the eyes with incomplete PVD, compared with 4.9% in the eyes without incomplete PVD. · Conclusions: Our results support the notion that the occurrence of incomplete PVD in RD is a significant risk factor for preoperative and postoperative PVR. Received: 18 June 1997 Revised version received: 9 October 1997 Accepted: 15 October 1997     

The development of severe proliferative vitreoretinopathy after retinal detachment surgery

A prospective clinical study was conducted to determine wether preoperative proliferative vitreoretinopathy (PVR), grade B, was a significant risk factor in the development of severe PVR after surgery for retinal detachment repair. Two series of consecutive retinal detachments associated with horseshoe retinal tears were compared. The first series included 40 eyes of 40 patients with preoperative PVR, grade O - A. The second series included 30 eyes of 27 patients with preoperative PVR, grade B. All eyes were operated on with conventional microsurgical techniques. At the first operation, no vitrectomies were carried out in any eyes. The incidence of postoperative PVR, grades C and D, was 20% (6/30 eyes) after a single operation in the series of eyes with preoperative PVR, grade B as compared to 0% in the series of eyes with preoperative PVR, grade O - A. The difference between the two groups was statistically significant (P = 0.01). It was also found that the incidence of postoperative proliferative PVR was significantly higher in eyes with preoperative vitreous hemorrhage (30.7%) as compared to eyes with no preoperative vitreous hemorrhage (0%;P = 0.02). Incomplete posterior vitreous detachment without collapse of the vitreous gel occurred significantly more frequently in eyes with preoperative proliferative vitreoretinopathy, grade B (68.4%, than in eyes with preoperative proliferative vitreoretinopathy, grade O - A(27.5%;P = 0.02).     

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

PURPOSE: To determine the prevalence of and risk factors for proliferatative vitreoretinopathy (PVR) in eyes with rhegmatogenous retinal detachment but no previous vitreoretinal surgery. DESIGN: Observational case series. METHODS: Prospective study. SETTING: A private vitreoretinal clinic in Caracas, Venezuela. STUDY POPULATION: 119 eyes of 119 patients who presented with rhegmatogenous retinal detachment but no previous vitreoretinal surgery between 1995 and 1998. OBSERVATION PROCEDURES: Data from detailed preoperative and postoperative examinations of each eye were recorded prospectively and entered into an electronic database. MAIN OUTCOME MEASURES: Prevalence 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. RESULTS: The 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. CONCLUSIONS: PVR 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.     

环扎加压术后玻璃体的短期改变

目的 分析环扎加压手术后玻璃体的短期改变。方法 采用超声和临床检查分析接受环扎加压术的76眼术前到术后短期内玻璃体的改变。结果41眼（53.9％）术后玻璃体内混浊物质增多。术前超声检查下后极区完全玻璃体后脱离（PVD）、部分PVD和无PVD者分别为20,34和22眼,而术后初次超声检查时则为46,26和4眼。结论在环扎加压术后,相当一部分眼术后短期内出现后极区PVD的范围迅速扩大。与黄斑中心凹周围相比,这种急性的PVD更多地首先发生于视盘区。     

Problems in pneumatic retinopexy

Fifty-four phakic eyes with selected rhegmatogenous retinal detachment (one retinal tear or a circumscribed group of tears in the upper two-thirds of the fundus, no sign of PVR) were treated by pneumatic retinopexy (transconjunctival cryopexy, intraocular gas injection with appropriate postoperative head positioning). After postoperative follow-up of six months or more primary reattachment of the retina was found in 27 patients (50%). In 12 eyes (22%) there was insufficient relief of traction, so that the detachment persisted (seven eyes) or recurred (five eyes). New retinal tears developed in 12 eyes (22%) between three days and six months postoperatively. This was probably due to interaction of the gas bubble with the vitreous base, an incompletely detached posterior vitreous border, or intravitreal condensations. Three eyes (6%) developed PVR. Other complications were vitreous hemorrhage (one eye) and subretinal gas bubble (one eye). The higher rate of complications, including the development of new tears, as compared to episcleral buckling procedures is discussed. In the authors's view appropriate experience on the part of the retinal surgeon and a level of intraoperative asepsis adequate for intraocular procedures are of major importance.     

Prognostic value of new retinal tears associated with the development of postoperative proliferative vitreoretinopathy

We prospectively evaluated for the presence of new retinal tears 60 eyes of 60 patients who developed recurrent retinal detachment complicated by proliferative vitreoretinopathy (PVR) after surgery for primary rhegmatogenous retinal detachment. New retinal tears associated with the development or recurrence of postoperative PVR were disclosed in 27 eyes (45%). New tears were categorized into two distinct groups: (1) peripheral new tears and (2) posterior new tears. Peripheral new tears were disclosed in 11 eyes. They were invariably located at the posterior edge of the vitreous base and showed a prevalence in the inferior quadrants. The prognosis for permanent retinal reattachment after reoperation was not influenced by the presence of peripheral new tears. Posterior new tears were disclosed in 19 eyes. They were located in the midperiphery or close to the posterior pole. They were more frequent in grade D PVR (57.7%) compared with grade C PVR (11.7%) (P< 0.01). Posterior new tears were associated with a poor prognosis. In grade D PVR the anatomic success rate following repeated surgery was only 13.3% (2/15 eyes), whereas all eyes with grade D PVR and no posterior new tears were successfully reattached (P<0.001). Failures to reattach the retina were related to recurrent PVR. It is concluded that the development of posterior new tears in postoperative PVR reflects a severe and active PVR process.Correspondence to: M. Bonnet     

Vitrectomy in Terson syndrome. Report of 18 cases]

A vitrectomy was performed in 18 eyes (15 patients) with vitreous hemorrhages due to Terson's syndrome. The average age of the patients was 46.5 +/- 14.4 years. The mean interval between the acute event of an intracranial hemorrhage and the vitrectomy was 6.8 +/- 4.9 months. The vitreous hemorrhage was associated with epiretinal membranes in 3, PVR in 2, and retinal breaks and/or rhegmatogenous retinal detachment in 3 eyes. The vitrectomy had to be combined with membrane peeling in 2, encircling procedures or exoplants in 4, cryotherapy in 5, endolaser in 1, and air/SF6 gas filling in 3 eyes. A missing or incomplete posterior vitreous detachment in 8 eyes was associated with a higher risk of PVR and retinal detachment. Two eyes with this condition needed 3 secondary operations. The mean follow-up duration was 32 (1 to 126) months. Two patients died 4 and 11 months after the operation. The visual acuity improved significantly following vitrectomy in all 18 eyes. The final visual acuity was better than 20/40 in 73% and 20/25 to 20/20 in 56%. The initial postoperative visual acuity decreased later on due to nuclear cataract in 7 of 10 eyes of patients over 45 years of age. A complicated cataract developed in only 1 of 8 eyes of younger patients who maintained a mean visual acuity of 20/25. Vitrectomy for Terson's syndrome is recommended in bilateral cases without spontaneous clearing of the vitreous within 3 months, as well as in cases with PVR and imminent retinal detachment.(ABSTRACT TRUNCATED AT 250 WORDS)     

Retinal detachment after cataract surgery

Background: A study of the characteristics and the results obtained in 99 consecutive eyes operated on for rhegmatogenous retinal detachment associated with aphakia or pseudophakia in order to find the predictive factors of poor anatomical and functional results. Methods: The authors retrospectively reviewed the files of 99 consecutive cases of aphakic and pseudophakic retinal detachment operated on by the same surgeon between January 1992 through July 1993 with a minimum follow-up of 6 months. Multivariate and chi square analysis were carried out. Results: Of the pseudophakic eyes, 25 had an anterior chamber lens and 48 had a posterior chamber lens. The posterior capsule was disrupted using a Yag laser in 58% of those with an posterior chamber lens but only 14% of them developed detachment within 6 months. The rate of vitreous loss was 27% with 5% in case of intracapsular extraction, 31% in case of extracapsular extraction and 54% in case of phacoemulsification. PVR was present in 30% of the patients and 51% of detachments occurred more than 24 months as a mean after cataract surgery. The overall anatomic reattachment rate was 88% with no significant difference between the aphakic and the pseudophakic patients, either with an anterior chamber of posterior chamber lens. Visual results were significantly worse in the anterior chamber lens group and in the aphakic eyes (P < 0.02). Negative prognostic indicators for reattachment included poor preoperative vision, extension of the retinal detachment to the macula (P < 0.05) and grades B, C or D proliferative vitreoretinopathy (P < 0.01). In addition to the above factors, eyes with vitreous loss, anterior chamber lens, aphakia and a larger extent of the retinal detachment had a poor visual outcome. Conclusion: Most aphakic or pseudophakic retinal detachment can now be reattached with either scleral or vitreo retinal surgery. The main difficulties are the localisation of the breaks and the treatment of PVR. Indirect ophthalmoscopy associated with vitrectomy does well in cases of an opacified posterior capsule. In cases of severe PVR long term internal tamponade either with C3F8 or silicone oil improves anatomical results but the functional results remain inferior.     

Risk factors for proliferative vitreoretinopathy after primary vitrectomy: a prospective study

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.