[Outpatient vitreoretinal surgery without next-day examination: Feasibility and acceptability]

Incidence of rhegmatogenous retinal detachment following macular surgery in France between 2006 and 2016

PURPOSE

To report the incidence of postoperative rhegmatogenous retinal detachment after macular surgery in France between 2006 and 2016 and identify associated factors.

DESIGN

Nationwide population-based cohort study.

METHODS

All surgical procedures for an epiretinal membrane or a macular hole performed in France from January 1, 2006 to October 31, 2016 were identified in the French national administrative database (Programme de Médicalisation des Systèmes d'Information). We investigated the incidence of rhegmatogenous retinal detachment occurring within 90 days of a macular surgical procedure.

RESULTS

From January 1, 2006 to October 31, 2016, 152,034 macular surgical procedures for epiretinal membranes or macular holes were recorded in France. We identified 3,605 cases of rhegmatogenous retinal detachment occurring within 90 days of the procedure. The incidence of rhegmatogenous retinal detachment was 2.37% overall, 1.95% for epiretinal membrane surgery and 3.43% for macular hole surgery. In multivariable Poisson regression analysis, rhegmatogenous retinal detachment was associated with macular hole surgery (incidence rate ratio [IRR], 1.76; 95% CI, 1.63-1.90; P < .001), history of cataract extraction in the previous year (IRR, 1.20; 95% CI, 1.08-1.34; P = .001), age < 60 years (P < .001), and male gender (IRR, 1.63; 95% CI, 1.51-1.76; P < .001).

CONCLUSIONS

The incidence of rhegmatogenous retinal detachment within 90 days of macular surgery was 2.37% overall in France between 2006 and 2016 and it was higher for macular hole surgery than for epiretinal membrane surgery.

Examining the Necessity of Postoperative Day-1 Review After Pars Plana Vitrectomy: A Meta-Analysis

BACKGROUND AND OBJECTIVES

This study aimed to evaluate the necessity of the postoperative day-1 (POD1) review after pars plana vitrectomy.

PATIENTS AND METHODS

The analysis included available literature that documented medical and surgical interventions performed on POD1 review after pars plana vitrectomy. A meta-analysis of proportions was conducted using a binomial-normal model to analyze three data sets consisting of all interventions, medical interventions, and surgical interventions. Heterogeneity and publication bias analyses were performed.

RESULTS

POD1 reviews of 2,262 patients across 14 studies were examined to yield a total POD1 intervention rate estimate of 4.7% (95% confidence interval [CI], 3.0-13.9). When stratified by medical or surgical intervention, the intervention rate estimates were 4.1% (95% CI, 1.4-11.6) and 0.7% (95% CI, 0.3-1.3), respectively. The most common complication requiring postoperative intervention was elevated intraocular pressure.

CONCLUSION

Given the wide confidence intervals of the estimated intervention rates, variability in postoperative practices, and range of interventions performed, the POD1 review cannot be discarded in its entirety. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:513-518.].